1805 Mayport Rd COMM23-0015 App and Docs Building Permit Application Updated 10/9/18
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City of Atlantic Beach Building Department **ALL INFORMATION ir
800 Seminole Road, Atlantic Beach, FL 32233
HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 145- fu i00- 1`"71.0 Permit Number: C.-c, (V\ in Z3- CO L.
Legal Description 14- I� -� u� � , 150 41-51L(ex o) pk�y RE# j/7, ID‘- cVv
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Valuation of Work(Replacement Cost)$ (5Db Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ONew 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 project? ❑Yes(must submit separate Tree Removal Permit) IrlNo
Describe in detail the type of work to be performed:
i i P6:4-7- vikilI 4o cont cel' gm°
it, 80,,tACUor
Florida Product Approval# for multiple products use product approval form
PropertOwner Information
Name S{,1 0rv.., d Address I5Z-0 +~-l.ir f4/1-
City
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City 4. 6, State F( Zip 3'L 23 3 Phone *
E-Mail _
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information ,(i �� �L�/
Name of Company Yl�(/T/ ( E. Qualifyi g Agent 14,4.,
Address Ik d fp✓�-- City State FL- Zip 3 ZZ-f5
Phone O 312 77-ZG Job Site Contact Number
State Certification/Registration# E-Mail ;,‘ (} '.`( i,,t L . id-+"'1.
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer / TAm�A- OR Exempt❑ Expiration Date '�/30/G7
3
Application is hereby made to obtain al 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
RECORDI,NG YOUR NOTICE OF COMMENCEMENT. Gl
(Signature of Owner or Agent) (Signature of Contractor)
7 C,.>
and sworn to o ffirmed)before me this dZiy of Signed and sworn to(or aff med) efore me his ay of
. Z0 y C,na.�s� L2c.r.a. Fe 6 ?e23, b i46 ,'me,
(Signature of Notary) ' na • . ► , ary)�
;'!:." ., TONI GINDLESPERGER pp ,,•4• TONT GINDLESPERGER
/Personally KI oV!n s MY COMMISSION#GG 353178 ]Personally Known OR :�: �„ :�
�t 1 MY COMMISSION#GG 353178
_ EXPIRES:October 6,2023 [ ]Produced Identificatio =�. '"A
[ ]Producedld(niti;'+;.� ,,• ;,,• ..w EXPIRES:October 6,2023
Bonded Thru Notary Public Underwriters Type of Identification: '.Fi;FF'
Type of Identifies YP Pdlb< r,gRubtihNndcrvrNers
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FIELD WORK DATE:v:1'25 REVISION DATES: 5'E" 41i018: 24 el /1
j CROCKETT LAW P.L. Ili - A eitj
i RUL MATE uGide'w 18033100 VVV ��
BOUNDARY SURVEY �/ `
DUVAL COUNTY 1 ( 72 + A1' 7 ,(-3
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PROPERTY ADDRESS F11803 3100 1 ZIDG 1 Y�\)C•I' 104 C .7o D IS
1805 MAYPORT ROAD, ATLANTIC BEACH,FLORIDA 32233 111
39.90'(P) GRAPHIC SCALE (In Fea
--., r • 1 Inch - 30 ft.LA S. . . ._. ._ vin, 11 THE ton.,40'OF Q?
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--O• ' . ,turG:re riapac.
# tIUT INCLUDED eki 51/ 1' g-
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.- _ s bB•17YX7 E 143.3r(M) expo-ace'�'lCC J R�
61S-r QI n::r !52.00(P) •ITf .
CLIENT ORDER NUMBER:2018-28 TATE Ow'OS/18Q 1 O I .�-
BUYER:CHELSEA LEONARD,JEFF LEONARD.AND GLORIA MOORE •S p _ - FEET ,.F.!.:-!]
16
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SELLER:ROBERT K.DETWILER - � 2l DI
CERTIFIED TO: / ipI i• ,GcBLLOT Ie5�1CHELSEA LEONARD.JEFF LEONARD,AND GLORIA MOORE; S if 0 p' /7W-54
CROCKETT LAW P.L.OLD REPUBLIC NATIONAL TITLEIr0y'vl:.-fINSURANCE COMPANY a ,N }�'r (-).
LOTS 1 AND 2.(EXCEPT THE NORTH 40 FEET THEREOF),BLOCK l Y 3�� .D "�-�S�D
19,DONNERS REPLAT,ACCORDING TO THE PLAT THEREOF,AS -.1.1/4..../ I 'i! N
RECORDED IN PLAT BOOK 19,PAGES 16 AND 16A,OF THE � `,
PUBLIC RECORDS OF DUVAL COUNTY,FLORIDA. a1 dL-1?-6,71-7.11,I I -,‘c"----------4,I b
�� t. 5 10 1 n �-r
__._. J / so.. ,.. r r�� BLOCK 19 i5D 1.5
N 90'OUCx7 E
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NONE VISIBLE -q 50'(F) c., �/ B.R.(A55
' . -.Ar Af zir, 7 ;_lra:,.,•,,,_,,, ,-,y,/ ,fry#,/ /6/
630
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BY PERFORMING A SEARCH WITH THE LOCAL GOVERNING •S.... 9 r 2.de5'aoT[a
MUNICIPALITY OR WWNI.FEMA.GOV,THE PROPERTY APPEARS TO �f1f' c4;. •ac'[.ma txss mace oA+aeRSnir+icr�erer�nwcD.
BE LOCATED IN ZONE X.THIS PROPERTY WAS FOUND IN THE No 39324".•. rese!e�rw rc+,ce:.oCAT+a+a+DRAw».c.
CITY OF ATLANTIC BEACH,COMMUNITY NUMBER 120075. /
DATED 06!03713, y f ' �.k�� •
1
Cc 1 �
I nereey G ddt,•-' .rIB Spire Me nevem(1 is a(rue
xxl a has oere mace&t .e p 90{70A
• my Rover lreiNce fo '. Ind raceaoC Erie1 a is a Pue da Board fa 2T.vesenrrai:�S'l�` , �4`+ "` \/ N E wTHE BEARING REFERENCE OF N90.00'DO•E IS BASED ON THEo/asurve Aa�p9A�etst'rbStarrC rxCcrseflaT,'rbyUmftvdaLLw:brXPraess+mal 1 }'XW Q
E: Sorveyws d AL$T�SA C 17 of ere arra ACmarsoaDre Cole ^l1
NORTHERLY RIGHT-OF-WAY UNE OF STANLEY ROAD.
€ DONNERS REPLAT,AS RECORDED IN PLAT BOOK 19,PAGES 16 S--(P <
AND 16A,OF THE PUBLIC RECORDS OF DUVAL COUNTY, J J
FLORIDA.
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_ -__...:. _.. _.._ ......_._.._._-_-----_-_—._.__.. __.._ Phone 866.7351916
Florida Land ...,:::======......___•__________-= Fax 866.74,4.2882
Title Association AFFILIATE _ — •^� _�. — ___� www.exactaland.com LAND
-FL-TA MEMBERS - _ •_. _ _.___,______._._.,._
._-1 ".'. .. ".." ' e.?III 11940 Fairway Lakes Driv
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�" ' \S CITY OF ATLANTIC BEACH
r ' ' 800 SEMINOLE ROAD
-'1,,,, =r ATLANTIC BEACH, FL 32233
(904)247-5800
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SURVEY AGREEMENT
NOTICE
All new projects creating more than 250 Square Feet of impervious surface or requiring on-site storm water
retention, including swimming pools,will require pre-construction and post-construction topographic surveys,
as required by COAB,Section 24-66 and described in Bulletin 2-18, Surveys. The surveys must be new
original documents, from a licensed surveyor, signed, sealed, and dated.
Other small projects, such as fences and construction less than 250 SF, will not require a new topographical
survey, but a current original-size survey with all relevant details is still needed. These surveys,when included
as part of a building permit application, must be complete, up-to-date, and original size and scale, as produced
by the surveyor.
Copies of old surveys lacking details or copies not of original size cannot be accepted. Building permit
applications with unacceptable surveys cannot be reviewed and the application will be returned to the
applicant.
Thank you for your cooperation in this matter.
AGREEMENT
I have read and understand the Notice above and affirm that the outdated survey I am
submitting is still accurate and complete, and all structures and impervious surfaces on the
property are shown on the survey.
I further understand that, if the survey is found to be inaccurate or incomplete, a $50.00 Plan
Resubmittal Fee will be charged; or if the permit has been issued, a Stop Work Order will be
posted with the associated $110.00 Fee.
)____JOB ADDRESS -)S /1710, (-)0_,- 60-e.
OWNER o CONTRACTOR(Pr t) /, �' / /At '
�j
Signature ` s � Date �'�5
1