1949 BRISTA DE MAR CIR RFNC22-0017 Permit ApplicationBuilding Permit Application Updated 10/9/18
s City of Atlantic Beach Building Department ALL INFORMATION
v,3
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us
IS REQUIRED. —
7
Job Address: Iu(11 1 A E Mi C t L. Permit Number: ` ` - C2 e- "OD
Legal Description Vv",3-7 3 •.2/C. "LV4,'V0 (Jv tor-,RE# i y.j('p
Valuation of Work (Replacement Cost)$ ,-S (r'() Heated/Cooled SF Non-Heated/Cooled
Class of Work: New Addition Alteration )2iitepair Move Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial ,esidential
If an existing structure, is a fire sprinkler system installed?: Yes ONo
Will tree(s) be removed in association with proposed prosect? Yes(must submit separate Tree Removal Permit) No
Qescribe ir,detail the type of work to be performed:'Y D CqZ:7 t' 1—e.,--A/GG /A.' ,7-OL ... N ,-t)37'
Florida Product Approval # for multiple products use product approval form
Property Owner Information
Name 714*IA5 ¢514 2-!2;/. J Address /01/47 32/5TA G/,C
City RTL.A'" C / -I" State Ft Zip 33-
2-33 Phone i- 3&3 999• 't
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company '364d1e PGeCrOz74 Qualifying Agent Jp.e.--1 It.[3 Lit S.i
Address $cm 4,144rk CC QtLrs54 City ,•A)( State FC— Zip 32- -- ?
Office Phone 9 CTLs -70s/ -j S-C- Job Site Contact Number
State Certification/Registration# E-Mail t3EACI eS P vs4A ( t-• (JT'--
Architect Name&Phone#
Engineer's Name& Phone#
Workers Compensation Insurer AM711415-s- OR Exempt tiPExpiration Date I / / 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 TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORD NG YOU OTICE OF COMMENCEMENT.
s/),(14 (IQ s
Signature of Owner or Agent) Signature of Contractor)
Sned and sworn to(or affirmed before me this day of Signed and sworn to(or affirmed) before me this a- day of
i•n.t r o o a )
ysr Notary Public State of Florida ' Notary Public State of FloridaJessicaADolquistJessicaADoiquist
MY Commission HH 142217IPersonallyKnownORExpires0E04/2025 Personally Known OR
wCommissionm25
142217
Expires(]
Produced Identification a Produced Identification
Type of Identification: V')l_ Type of Identification:
ik.
Fence Addendum Updated 1/14/2021
City of Atlantic Beach Building Department
1
800 Seminole Road, Atlantic Beach, FL 32233 PERMIT#
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date:
je) 9 &tf S7-A .?E c/l" _ L "z"-
Property Type: Lot Type/ Features:
2 Rroesidential IrOne 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 Four Foot(4ft)
Chain Link J4ix Foot(6ft)
Vinyl Other
El 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?
7 Yes (must submit separate Revocable Encroachment Agreement)
No
Will tree(s) be removed in association with proposed project?
El Yes (must submit separate Tree Removal Permit)
X 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.
LA''I \ REVOCABLE ENCROACHMENT AGREEMENT
6 City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FLC32233
ALL INFORMATION
HIGHLIGHTED IN GRAY
iiIS REQUIRED.
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
3\,-1 YNC OC"").-\r" 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 T-e:_C
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 1 L4 l ?1•(--t s'ca 6 _ A - Ci J'C-Ce__ .
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 hereby assumed by the USER.
7j1\_"-.-J.-t_ Date r G-- -
Property Owner/Agent(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this
J
day of cC' .i 20 2-2,_
by 3f1V) Y--\\u', who personally appeared before me and
rinted name of Signer)
ack ledge. th.t - she signe• the instrument voluntarily for the purpose expressed in it.it
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a,
1111 Ihk TONI GINDLESPERGER
1....! „ ,1 MY COMMISSION Department Approval:SSION#GG 353176Signature
gm
of Notary Public,State of ' ori•a '_='1-; EXPIRES:October6,2023
Personally Known
oc,.
B NotaryPublicUndarwrIersn.n„.., . . . _, .--,._-
Produced Identification(Type) . .
I
Scott Williams, Public Works Director
H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18
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BOUNDARY SURVEY
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SURI/E'20'U.E./D.E.INOTES6girJRZ= 7;511/ECROSS THE PROPERTY 1.7'
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LINE ON NORTHERLY S/DEO=LOT 0.2' ,,. 9_— X3.2_ —
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THERE ARE FENCES NEAR THE BOUNDARY
SET 1/2" S89°08'46"W 143.00' SET 1/2"IRON ROD IRON ROD IOFTHEPROPERTYANDCROSSINTOTHELB#7893 LB#789320'U.E./D.E.AND 10'U.E./D.E. ON SOUTHERLY 12 Z , IANDWESTERLYSIDEOFLOT
THERE ARE FENCES NEAR THE BOUNDARY
OF THE PROPERTY AND CROSS THE PROPERTYLINEONWESTERLYSIDEOFLOT.
sz=:a°ac7 ;-=-^ws r: -z-rnw .M-^ s ,u .,R.. .x :.W, Yz;;as•.z_.- - , erxrs xr:saaa,ljN0
j '' No.6415 SURVEYORS CERTIFICATE f_
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I HEREBY CERTIFY THATTHIS BOUNDARY SURVEYW
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IS A TRUE AND CORRECT REPRESENTATION OF A T RVEG'SURVEY PREPARED UNDER MYDIRECTION,NOTVALID WITHOUT AN AUTHENTICATED ELECTRONIC
kr
STATE OF SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL.ORA RAISED EMBOSSED SEAL AND SIGNATOR LB#7893
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SERVING FLORIDA
6250 N.MILITARY TRAIL.SUITE 102
WEST PALM BEACH,FL 33407SIGNED) PHONE (5611640-4600
IKENNETHJOSBRONESTATEWIDEPHONE (800)2264807PROFESSIONALSURVEYORANDMAPPER#6415 NOTCop w. upAi t STATEWIDE FACSIMILE (800)741-0576t47t-g- 2n.--.......,s WEBSITE: htlp:/rtarUetsurveyina.ne i
iLEGALDESCRIPTIONANDCERTIFICATION
Lot 86. SELVA NOR;E'UNIT TWO.according to the Plat thereof as recorded in Plat Book 40. Pages 37 and 37A.ofthe Public Records ofDUVALCounty.Florida.
Community Number. 120075 Panel:0407 Suffix:H Flood Zone X Field Work: 1/9/2018
Certified To
THE LAW OFFICES OF ROD SCHLOTH.PA;OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
Property Address
1949 BRISTA DE MAR CIRCLE
ATLANTIC BEACH,FL 32233
Survey Number.312956
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Client File Number:RS 18-5359
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ABBREVIATION DESCRIPTION:
A.E. ANCHOR EASEMENT F.F.FELEVATION O.RB. OFFICIAL RECORDS BOOK SYMBOL DESCRIPTIONS:
AIC AIR CONDITIONER F.I.P.
FINISH FLOOR
B M BENCH I . FOUND IRON PIPE P) PLAT
B.R.
BENCH
MARK
ER=_NCE
FIR FOUND IRON ROD
P.C.•
B. PLAT BOOK CATCH BASINFPXFOUNDPARKER-KALON NAIL POINT OF CURVATURE MISC.FENCE .IC) CALCULATED L) LENGTH P.C.C. POINT OF COMPOUND CURVE Q =CENTERLINE ROADLCENTRAIDELTAANGLELAGLIMITEDACCESSEASEMENTP.O.B. POINT OF BEGINNING PROPERTYCORNERCH
DEED lDESCRIPTION FI
CHORDf'D L•AIE LAKE MAINTENANCE EASEMENT P.O.C. POINT OF COMMENCEMENT 1, 1 °COVERED AREA Ue =
UTILITY BOX
D.= DRAINAGE EASEMENT
IMi MEASURED RED VERIFIED P.R.C. POINT OF REVERSECURVE a.XXX=EXISTING ELEVATION c--u.P. =
UTILITY POLEM.H. MANHOLE P.T. POINT OF TANGENCYD.H. DRILL HOLE N&D NAIL&DISK RM' RIGHT-OFF-WAY HYDRANT FT,mDMDRIVEWAY WATER METER'N.R.E.O.W. EDGE OF WATER NOT RADIA R) RADIAL!RADIUS
MANHOLENTSNOTTOSCALES.I.R. SET IRON ROD WELLF.C.AL FOUND CONCRETE MONUMENT O.H.L OVERHEAD UTILITY LINES T.O.E. TOP OF BANK
U.E. UTILITY EASE ENT METAL INCE WOOD FENCE
t
PAGE l OF 2 PAGES
NOTCOMPLETE WITHOUT PAGE2
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1 GENERAL NOTES:
T1) LEGAL DESCRIPTION ROVID=D BY OTHERS E2THELANDSSHOWNHEEREONWERENOTABSTRACTEDFOREASEMENTSQROTHERRECORDEDENCUMBRANCESNOTSHOWNONTHEPLAT.3) UNDERGROUNDRPORTIONS OF FOOTINGS,FOUNDATIONS OP.OTHER IMPROVEMENTS SL7' (WERE NOT LOCATED.
v4) WALL TIES ARE TO THE FACE OF THE WALL AND ARE NOT TO BE USED TO RECONSTRUCTLB#7893BOUNDARYLINES.
TED.6) DDIMENSIONS SHOWN ARE PLAT
ANY
VISIBLE ENCROACHMENTS DMEASURED UNLESS OTHERWISE SHOWN.7) FENCE OWNERSHIP NOT DETERMINED. SERVING FLORIDA
8! `LEVATIONS INDICATED H=R=ON ARE IN EE AND DECIMALS RE,--R=NCS TO N G V.D,192E 6250 N.MILITARY TRAIL.SUITE 1G29.) IN SOME INSTANCES,GRAPHIC REPRESENTATIONS HAVE BEEN EXAGGERATED TO MORE WEST PALM KACIFL 3340CLEARLYILLUSTRATERELATIONSHIPSBETWEENPHYSICALIMPROVEMENTSAND/OR LOT LINES. PHONE (561)640-48001INALLCASES.DIMENSIONS SHALLCONTROL THE LOCATION OF THE IMPROVEMENTS OVER STATEWIDE PHONE (800)n6-4807741-
057601
SCALED POSITIONS.
STATEWIDE FACSIMILE {800)
5, WEBSITE: hhp:!lfargelsurreying.ne!