375 SEMINOLE RD RFNC22-0118 (2) Permit ApplicationJ"teak!
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Building Permit Application
4' filCityofAtlanticBeachBuildingDepartment u ihttOP.MATION
GNllG1i7 D 1N GRAYax
4!' SOO Seminole Road,Atlantic Beach,FL 32233 REQUIRED.
wi
Phone:
n (
904) 247-5826f Email:
rBuilding-
Dept@coah.us
Sob Address:J it 1tJL( Permit Nvr.+b { `L v l C—L 1 l g
Legal Description to-i5 ‘i0-25-20) E. eO'n 2 cillc..cif- REu 1-701-435 - 0Vt.9V
V
d
Vahuitbon of Worts{Replacr enI
C054SGti
Healed/Cooled Non-Hee
Class of Work; )iNew (DAddhlon OAfilratiCas 12.Repair rCMove L2 rIPool LWindo*/0oou
Use of erastit /propo>rd strurturrls): CCornmerciai R,esdential
If an eusting structure.is a fire sprinkler system installed? OYes 0 N o
Will treel5l be rcn rYed in assoCiutron with oro tilt.orol.tt?CYt tp s vtarnit seoarattc34e R moval P rrlit INQ'
Describe i ate the t of w pry W.,Ag- .1.9..%....
c)., , I.”,....Q1 mi. Vt..,.
Fiord Product Approval a for multip're produtls use prOtlt:ct approvar'or1•1
Pr•!awry Owner Inf•rn tiOn
f l4 Q
Name Tog frSdr SST f
Lea
city-A. t b' urs lo.ada stated L. zip 7,] Phone
E-Mail' MIT P l i - S. ill
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) J..
Contractor Inform- 1
Name of compp, 1R r u.sl t arir+
5 ._
AdCress'' A lr h )d City X ______,,state__ _7i
or
Office Phone Arl ` '' Job Site Contact Numb r I7"` "-
State Ctrci}cartiort/Rrglstrativn d r _ t•Maf s./r I . i r e.
Architect Name&Phone a F
Engineer's Name&Phone>' e_._
Workers Compensation Insurer f /011 Eytrmpt EApiratior Date
Application is hereby made to obtain a permit to do the worx and installations as indicated.I certify that no work be krstaJfation has
commenced prior to the issuance of a permit and that all woe.will tie•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 W'ORtt,PLUMBING,SIGNS.
WELLS.POOLS.FURNACES,80111/1S.HEATERS,TANKS,and AIR COND4T1ONERS.etc. NOTICE:In addition to the requirements of this
permit there may be additional restrictions applicable to this property that nury 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 ageruies.
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 OBTAIFHNANC ,COSULT W • YOUR LENDER OR • O' -•TT ' BEFORE
RECORD!la NO E••F CO E • ENT.
00f
1 or mature° C.ontrartor)Signature of th or Awe ty
qred attd sworn to(or a i bet rr rile this ay of Signed and swore.tp Ito affirmed)before me Nis day o!
Q[i't !D22... •1C v r DJ , .... - .by
l:,3.Y.tLESFERci:- to, aret f L` natant of Notary)
tAtt>SatQ'o-.yG"?
T I .t Y..
y
f,W~+.08ERT1=
i/77
RES.C-
1 P rnun,atir toitmo i 4;r,s.,,w''.- ' I I Personally Known OR I `R,Notary Public-State of Florida
4Prorkreeel • "cation d,rIIProced tdrntrfocat+cvs :Tr Commission 0 GG 949232
rype Of tdentrficatiow In*of identification 1%., / YCumnt_Expires may 15,2024 r
impuisBonded throu4l+Nattorai Natary Assn. 1
Js
s Fence Addendum Updated 1/14/2021
7IK;) City of Atlantic Beach Building Department
fri/PY 800 Seminole Road, Atlantic Beach, FL 32233 PERMIT #
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address:Date:
unfic Baeh, f 32233
Property Type: Lot Type/ Features:
Residential One Street frontage (interior lot)
Commercial More than one street frontage (corner lot, through lot,
etc.)
Swimming Pool
Fence Material: ftC.yvkes Fence Height (select all that apply):
Wood
Wi°
Four Foot (4ft)
Chain Link Six Foot (6ft)
Vinyl 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)
X] 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.
MAP SHOWING BOUNDARY SURVEY OF
LOT 273, PLAT OF SECTION NO. 2. SALTAIR AS RECORDED IN PLAT BOOK 10, PACE 15.
OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY. FLORIDA.
CERTIFIED TO:
IRIS U. LOPEZ
SEMINOLE ROAD
VORKRLY ALT bOIAEVARO PER TNT PLAT)
DO' fC41 Dr RAY)
N 44'56'59" E
49.86' (MEASURED)
Popo j" N 45'00'OO' E 50.00' (PLAT) ' °w,, . „a 1
h .SVO'00' C (
t: 10307 (PLAT)
W
of.' I d 1
1•-• 44..
y
Q ii
0.W
Q '• '7 t
74.1 Q Q i
0
ONE STORY
MASONRY
POSTED / 375 P w
E
24 8 0
L•fit
8g 8
F 8Q
v1 Y M r 0
t z A v
Z CM
F
LOT 274 I LOT 273 I LOT 272
Or4g..„16RAl Pre r
I:P .%45'00'00 w 50.00 (PLAT) f0 T/1(A71p.1
S 44'55'28' W
49.98' (MEASURED)
TOT 288 LOT 285 LOT 284
SIM TOMS IMP
q+ AC1YtIp it j
Mel IP A*4 a etifoiTe.ai
X)8 ( 15-048 f DATE OF FIELD SURVEY: 04-26-15 bDATE OF ISSUE: 04-28-15 ] SCALE: 1' .. 20'
CLOT-NG COORDINATED BY. YAP NOTL4
RICHARD T. YOREHEAD TITLE & ESCROW, INC. T. litM2,10 ARI *ASO O+ Trt ASRMD e0R'»0 Or 4 43V".7. * ALOOCTK
30UT1ncruaLr WLMARDY Log cr yuWICT PARCLL.444 THIRD STREET
1 MEOTUIE BEALH, 1. 32286 2- RV ROTT r CHIT TK CAPTIO
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940144 ON MC RATIONAL 11000 NSURM+CT YAP DAM°AMC 3. 2013, CO.oRarin
904) 241-5147 MAeOt 129075.ARIIZ 91a M
3. THIS AIRVIY RCA CTS ALL LASEWOLTS! MOM 9f WAY AS KR RCOORMD KAT. to6,03
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nil..- ..— COtTIFYI4C'AVM'.
CHARLES K. CERTIFICATE LEGEND:
I IOIQT Wr4 T 4441 143 1I4rKY*N root VWI rt RO OA/LL*MACS 0 . PROPERTY CORN,
Aro YQYf M WAN TIO.K.AA 17400.004 4t Y /CAW N M MOW:.OISTROCTED MO IVOQIU
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4MA/'RW05.101 K-" #
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