1291 LINKSIDE DR RFNC23-0035 �t::„v ,ri.. Building Permit Application Updated 10/9/18
J •j�S�I
City of Atlantic Beach Building Department **ALL INFORMATION
J ./ 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
J''- 0) IS REQUIRED.
Phone: (9247-5826 Email43uilding-Dept@coab.us
Job Address:� � I �i.V ) ;� ��. Permit Number:1 \ Fly;C �� - b 03 5
Legal Description ce 1Vj� ��
r. Lit cf/� RA;-1 1 Lcl !.j q -23.-/ l 2 E RE# t 2 741-538O
Valuation of Work(Replacement Cost)$ .7775— Heated/Cooled SF Non-Heated/Cooled
• Class of Work: 1 JNew ❑Addition ❑Alteration ❑Repair ❑Move ODemo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial ❑Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes (NrNo
• Will tree(s) be removed in association with pro osed project? ❑Yes`must submit cepa •te Tree Removal Permit) ❑No
�Deesscribe in detail th type of work be perfor ed: D//tJ,9Co f/ s--,, j 7 /�
7fae
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Namektv!` PI`. 77 ,ewµ5,P,Pt,t'�7-1 Address 124-7/ j.tvtlr' ice' ArCity /14)4,4.47eVz11 State rj� Zip 31 23',1 Phone %0! 32/3-13Z
gib E-Mail may-4,r, Pc,F e e6%,vt LaTI.N e+
Owner or Agent(If Agent, faower of Attorney or Agency Letter Required)
Contractor Information
Name of ComioaRy /v,- NCS
Qualifying Agent Ag.g...--/ g...Z __.-
Address/ ' /0' , L f '/iv Na " // I City i State L Zip j72.2-6
Office Phone G/025 f Job Site Contact Number Sir - e. f
State Certification/Registration#I E-Mail_f 7J_ ' 9 4 %% dG0 �,2..,
Architect Name&Phone#
Engineer's Name&Phone# G` III
Insurer / '
Workers Compensation
I l l J(� OR Exempt❑ Expiration Date
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 OBTAI INANCING, CONSULT WITH YOUR LENDER O' , : ATT• EY BEF• :E
RECORDI ( O,d e , a c I• COMMENCEMENT. / �' / ,/
(Signature • wner or Agent) / (Signature of Contractor)
ed and worn to(or a'irm- t)bef.re met is 2ay of Signed and sworn to or affirmed) before me this ay of
I , I'N ? -z ,. '. kl• t s . . Bch , 'art by l
Aniziii
'atu �� ill111..— a ure of ary
_...-{-1-Personally Known OR •. TONI GINDLESPERGER Personal/ Known OR
�:, Y `:� ‘ Notary Public•State o
[ ]Produced Identification '` .: MY COMMISSION#GG 353178 [ )Produced Identification GG 9a9''
�Q Commrss
o EXPIRES:Cc',ober 6,2023 Type of Identification: ,\. 'r My Comm Ex et.mer•c k
Type of Identification: -�Qe YP oonded tbrougn Na.Cr n-, -.,gW
„�_ ,,.f°' Bonded Thru Notary Public Underwriters
MAP SHOWING BOUNDARY SURVEY OF
LOT 75 BLOCK _ AS SHOWN ON MAP OF
SELYA L JNK$IOF UNIT /
AS RECORDED IN PLAT BOOK 0 PAGES aj#434 OF THE CURRENT PUBLIC RECORDS OF DUVAL CO.. FLA
FOR: cEN7'Ex NDMES covP
NOTE BEARINGS SHOWN HEREON ARE BASED ON THE ABOVE MENTIONED PLAT
PA.1T & SECTION I7, 7DIV.V.7H/P Z sou TN, 1t4.i Z urAsr
(SEL VA UAA#WA CDI.wrY CL Uta OKf OR/v/M6 .rAV e)
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/ (50 EASEMENT FOR DRA/NAGE,
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.-t!..An;=;, REVOCABLE ENCROACHMENT AGREEMENT
. '\ City of Atlantic Beach **ALL INFORMATION
11) 800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
/ IS REQUIRED.
cm, %
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
1 Z q ( 1_t n S e c' & of Atlantic Beach, Florida, hereinafter
referred to as"USER". 1"\\_a- k 1 O
WI N SSETH:
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 t City of Atlantic Beach.
This work is generally described as e rvo .
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 CI1 to U ER,said notice to USER shall be given by certified mail,return
receipt requested,to the following address Z I Ll n k S t de_ .
• 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.
/111c 4p7 . l 7 ,?ie....%.4. Ped p )...,1,4--/- Date 3/2212o2 3
Property Own /' .e00,.(s .•4 presence of Nbtary Public)
STATE OF FL RIDA,COUNTY OF/R AL 1n
The foregoing instrument was acknowledged this 7 Z day of 1 a ' , 20 7
if
by `" tj -V k 4 �G pla , who personally appeared before me and
• ted name of Si:ne
ackn,' . : :ged that hidled the instrument voluntarily for the purpose expressed in it.
Department Approval:
Signature of Notary Public,Stat f Florida �3`;`Y'P`�� TONT G COMMISSION
#ERGER
':,= MY COMMISSION#GG 353178
[ ] Personally Known 1'-w
t:;;.,�;o; EXPIRES;October 6,2023
e°F F` Scott Williams, Public Works Director
[ ] Produced Identification(Type) ••...,,... Bonded Thru Notary Public Underwriters
H:\Applications&Forms\Word Documents\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18
Fence Addendum Updated 1/14/2021
City of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233 PERMIT #
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date:
I2 ii Zev►L2icit Dvtve, 37262 Z02-73
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: Fence Height (select all that apply):
Wood ❑ 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)
Will tree(s) be removed in association with proposed project?
❑ Yes (must submit separate Tree Removal Permit)
�N o
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.
A/Cris:LK XI
7ruatets
Upon my death, incapacity or incompetence (as defined in
Article II), or In the event I shall resign or fail cr cease to
serve AS Trustee for any other reason. my sons. MARK X. PCPP,
JEFFERY W. POFP and .JAMES D. PON', shawl automatically serve as
successor ce-Trustees. Otheiwiso, no sw-ceseor heed be
appointed.
Any *uCCSSOf Trustee shall serve with all the powers,
discretivna and immunities herein grAnted to my Trustees, shall
have no duty to investigate or Inquire into the acts of a
former TrJstee, and shall have no liabtlity for acts or
omissions of a former Trustee.
WICISJUI
KaircellAntauS
(a) This Trust Agreement is a Florida contract and it
shall be construed according to and governed by the laws of the
State of Florida.
(b) The headings used herein are intended solely for use
as reference and aro not intended to be a part of this
Agreement.
(c) Where necessary or Appropriate to the meaning hereof,
the singular and plural shall be interchangeable, and words of
arY gender shall include All genders,
-9-
71: WITNN5S wirRror. the Truatea and 1 have duly exec,atea
this Truant Agreement the day and year first above written.
F .
PP
Gres .r and Trustee
The foregoing was published, declared and Signed y
JtAN 5,
PGpp, in our presence, as and to be her Truest Agreement and we,
at her request, in hear presence arsd in the presence of each
other, hereby eubscrlte es attesting witnessea.
r
of Jacksonville.. Florida
4f, ,,, <i./C et Jacksonville, Florida