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88 Nicole Ln RESO23-0046 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP: RUTT AMY LYNN 88 NICOLE LN ATLANTIC BEACH FL 32233 COMPANY:ADDRESS:CITY:STATE:ZIP: TYPE OF CONSTRUCTION: REAL ESTATE NUMBER:ZONING:BUILDING USE GROUP:SUBDIVISION: 169519 0715 TIFFANY BY THE SEA JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK: 88 NICOLE LN RESIDENTIAL OTHER SINGLE OR TWO FAMILY RESIDENTIAL OTHER SYNTHETIC TURF $22000.00 LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 1 PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL Notes: Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line (904-247- 5814) to request an Erosion and Sediment Control Inspection prior to start of construction. 2 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. 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. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES . ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY. 1 of 2Issued Date: 5/15/2023 PERMIT NUMBER RESO23-0046 ISSUED: 5/15/2023 EXPIRES: 11/11/2023 RESIDENTIAL OTHER PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 WORK WITHOUT PERMIT 455-0000-322-1000 0 $110.00 TOTAL: $135.00 3 PUBLIC WORKS DUMPSTERS/ROLL-OFF CONTAINERS INFORMATIONAL Notes: Dumpsters and roll-off containers must be used in compliance with Section 16-8 and must comply with all standards, per City code. 4 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration, including sod, is required. 5 PUBLIC WORKS CONSTRUCTION SITE MANAGEMENT INFORMATIONAL Notes: Provide construction site management plan, including location of silt fence, dumpster, portable toilet. Right-of-Way Permit is required if using right-of- way for construction parking. 6 PUBLIC WORKS GRASS INFORMATIONAL Notes: Full site to be grassed. 7 PUBLIC WORKS REVISION INFORMATIONAL Notes: Any plan change must be submitted as a Revision to the Building Department. 8 PUBLIC WORKS DEBRIS REMOVED INFORMATIONAL Notes: All construction debris must be removed from job site by Owner. 9 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL Notes: Any damage done to infrastructure must be repaired by Owner. 10 PUBLIC WORKS OTHER PUBLIC WORKS CONDITION INFORMATIONAL Notes: Artificial turf cannot be installed in the City right-of-way. 2 of 2Issued Date: 5/15/2023 PERMIT NUMBER RESO23-0046 ISSUED: 5/15/2023 EXPIRES: 11/11/2023 RESIDENTIAL OTHER PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 Final Plumbing Final Electrical Final HVAC CC Final Final Building* Swimming Pool Steel Swimming Pool Safety Electrical Grounding & Bonding Swimming Pool Final (Bldg) Swimming Pool Final (PW) Formed Columns/ Beams* Masonry Cell Fill Structural Steel* OTHER: OTHER: OTHER: OTHER: OTHER: Power Pole Silt Fence Piers/ Stem Walls Underground Plumbing Underground Electric Foundation/ Footing Slab** Retaining Wall Footing Driveway Sewer (Building Dept) Sewer Tap (Utilities Dept) Rough Electric* Rough Plumbing/ Top Out* Rough Mechanical* House Wrap Wall Sheathing Roof Sheathing Tie-down Framing Connections Rough Framing Roofing In Progress Window/Door In-Progress Insulation Ceiling Insulation Wall Exterior Lath Stucco Scratch Coat Exterior Siding In-Progress Brick Flashing & Ties Early Power Gas Rough Gas Final* * When all rough electric, plumbing, mechanical are complete but before any work is covered up. * When all gas piping is complete and wallboard is installed but before gas is attached to any appliance. All outlets must be capped and pipe pressurized at a minimum of 15 lbs. * For new living space: When all construction work including electrical, plumbing, mechanical, exterior finish, grading, required paving and landscaping is complete and the building is ready for occupancy, but before being occupied Additional inspections may apply to your project if your project contains these elements: INSPECTIONS REQUIRED FOR BUILDING PERMITS To verify compliance with building codes, inspections of the work authorized are required at various points of the construction. The following inspections are typically required for residential projects: Date: Initial: Date: Initial: _____________________________________________________ Permit Type ____________________________________________________ Permit No. __________________________________________________________ Job Address ____________________________________________________ Contractor POST THIS CARD WITH PERMITS AND PERMIT DOCUMENTATION IN FRONT OF BUILDING Construction Hours per City Code: 7am—7pm Weekdays; 9am—7pm Weekends Building Department Public Works/Utilities Fire Department Phone: 904-247-5826 Phone: 904-247-5834 Phone: 904-630-4789 Fax: 904-247-5845 Fax: 904-247-5843 Fax: 904-630-4203 * When forms and reinforcing steel, anchor bolts, sleeves and inserts, and all electrical, plumbing and mechanical work is in place, but before concrete is poured. * When all structural steel members are in place and all connections are complete, but before such work is covered or concealed. ** FORM BOARD ELEVATION CERTIFICATE MUST BE ON-SITE FOR SLAB INSPECTION SYNTHETIC TURF 88 NICOLE LN RESO23-0046 Building Permit Application Updated 10/9/18 City of Atlantic Beach Building Department 800 Seminole Road, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: _______________________________________________________ Permit Number: ____________________________ Legal Description ________________________________________________________________ RE# _________________________ Valuation of Work (Replacement Cost) $_________________ Heated/Cooled SF ___________ 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 project? □Yes (must submit separate Tree Removal Permit) □No Describe in detail the type of work to be performed: Florida Product Approval #______________________________________________ for multiple products use product approval form Property Owner Information Name ______________________________________________ Address _________________________________________________ City ____________________________________ State _______ Zip _______________ Phone ________________________________ E-Mail ______________________________________________________________________________________________________ Owner or Agent (If Agent, Power of Attorney or Agency Letter Required) _________________________________________________ Contractor Information Name of Company _______________________________________ Qualifying Agent _______________________________________ Address________________________________________________ City___________________ State ________ Zip_______________ Office Phone ____________________________________ Job Site Contact Number _______________________________________ State Certification/Registration # ____________________ E-Mail_______________________________________________________ Architect Name & Phone # ______________________________________________________________________________________ Engineer’s Name & Phone # _____________________________________________________________________________________ Workers Compensation Insurer _____________________________________ 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 OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ___________________________________________________ (Signature of Owner or Agent) Signed and sworn to (or affirmed) before me this ____ day of ___________, ________, by ____________________________ ________________________________ (Signature of Notary) [ ] Personally Known OR [ ] Produced Identification Type of Identification: ______________________________________ ___________________________________________________ (Signature of Contractor) Signed and sworn to (or affirmed) before me this ____ day of ___________, ________, by ____________________________ ________________________________ (Signature of Notary) [ ] Personally Known OR [ ] Produced Identification Type of Identification: ______________________________________ **ALL INFORMATION HIGHLIGHTED IN GRAY IS REQUIRED. None None 05/01/2023 May 1st 2023 Amy Lynn Rutt Notary Public, State of Texas State: Texas County: Harris DRIVER LICENSE Notarized online using audio-video communication Updated 3/11/2014 PRODUCT DATA SHEET Collection Group: Pet Turf Product Name: SYNLawn Pet Platinum Product Code: Applications: Kennels and Pet Areas Product Specification: Physical Property Physical Characteristic Method of Determination Yarn Type: Grass Zone™ Yarn Type: Thatch Zone™ EPN Nylon w/HeatBlock™ Texturized Nylon w/HeatBlock™ n/a n/a Yarn Color: Grass Zone™ Yarn Color: Thatch Zone™ Turf Green Turf/Tan n/a n/a Pile Height: Grass Zone™ Pile Height: Thatch Zone™ 1 ¾” 1 ½” +/- 15% ASTM D 5823 ASTM D 5823 Pile Weight: Grass Zone™ Pile Weight: Thatch Zone™ Total Pile Weight: 28 oz. 28 oz. 56 oz. ASTM D 5848 ASTM D 5848 ASTM D 5848 Yarn Denier: Grass Zone™ Yarn Denier: Thatch Zone™ Yarn Denier: Thatch Zone™ 4200/8 4200/8 D 5040/12 D ASTM D 1557 ASTM D 1557 ASTM D 1557 Primary Backing: Secondary Backing: Secondary Cushion Weight: Total Fabric Weight: Fabric Width: 8.0 oz.Woven 20.0 oz. EnviroLoc™ n/a 84 oz./sy 15 feet ASTM D 5848 ASTM D 5848 ASTM D 5848 ASTM D 5848 n/a Tuft Gauge: Tuft Bind: 3/8 > 8 lb. ASTM D 5793 ASTM D 1335 Flammability: (Pill Test) Flammability: (Critical Radiant Flux) Shock Absorbing Properties Water Permeability: *Lead Levels Pass n/a n/a > 30 Inches per hour Compliant ASTM D 2859 ASTM E 108 ASTM F 355 ASTM F 1551 ASTM F 2765-09 Warranty Period: Material Safety Data Sheets See applicable Warranty Chart Provided upon request 29CFR1910.1200 Physical characteristics may vary within industry standards. *Meets all Federal and State of California minimum lead level requirements FEATURES BENEFITS EPN NYLON  Innovative technology process produces a highly resilient yet exceptionally soft fiber to give a robust groomed appearance  Protects against melting from reflective sunlight ENVIROLOC™  Incorporates BioCel™ technology with one of the most technically advanced and environmentally friendly backing systems in the industry  60 – 70% green by weight; greater dimensional stability HeatBlock™ Technology  Infrared reflectors in yarn makes yarn up to 15% cooler than other yarns Updated 10/24/18 Owner Builder Affidavit **ALL INFORMATION HIGHLIGHTED IN GRAY IS REQUIRED. City of Atlantic Beach Building Department 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT #: _____________________ I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 “CONSTRUCTION CONTRACTING” REQUIRES OWNER / BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU, AS THE OWNER OF YOUR PROPERTY, TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER’S COMPENSATION INSURANCE BE PURCHASED. . III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN “OCCUPATIONAL LICENSE” IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY “CERTIFICATE OF COMPETENCY” OR THE FLORIDA “CONTRACTORS CERTIFICATE” TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT (904- 247-5826 OR BUILDING-DEPT@COAB.US ) IF IN DOUBT. V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. Job Address: ______________________________________________________________________________________ Owner Name: ____________________ _______ Phone Number: Mailing Address: City: ___________________ State: ___________ Zip: Notarized Signature of Owner The foregoing instrument was acknowledged before me this _____day of ___________, 20___, in the State of Florida, County of _________________ Signature of Notary Public __________________________________________________ [ ] Personally Known OR [ ] Produced Identification Type of Identification: _____________________________________________________ 32233 570-885-5770 Atlantic Beach88 Nicole Lane FL 88 Nicole Lane, Atlantic Beach, Florida 32233 Amy Rutt 2nd May 23 XXXXX Texas Harris DRIVER LICENSE Notarized online using audio-video communication Notary Public, State of Texas Revision Date: 4/6/2023 REVOCABLE ENCROACHMENT AGREEMENT City of Atlantic Beach 800 Seminole Road, Atlantic Beach, FL 32233 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 __________________________________________________________________ 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 _____________________________________________________________________. 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 ______________________________________________________________.  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. ________________________________________________________________ Date________________________ Property Owner/Agent (signed in presence of Notary Public) STATE OF FLORIDA, COUNTY OF DUVAL The foregoing instrument was acknowledged this ___________ day of __________________________, 20 ___________, by ______________________________________________________ (printed name of Signer), who personally appeared before me and acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. ________________________________________________ Department Approval: Signature of Notary Public, State of Florida [ ] Personally Known _________________________________________________________ [ ] Produced Identification (Type) ______________ Public Works Director Date **ALL INFORMATION HIGHLIGHTED IN GRAY IS REQUIRED. 05/02/2023 XXXXXX Texas XXXXX Harris 2nd 23May XXXXX Texas Amy Lynn Rutt DRIVER LICENSE Notarized online using audio-video communication H:\Applications & Forms\Word Documents\201801001 Right-of-Way Easement Permit Application.docx Revision Date: 10/1/18 **ALL INFORMATION HIGHLIGHTED IN GRAY IS REQUIRED. RIGHT-OF-WAY / EASEMENT PERMIT APPLICATION City of Atlantic Beach 800 Seminole Road, Atlantic Beach, FL 32233 PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES Job Address_________________________________________________ Permit Number________________________ Contractor Information Company______________________________________________ Qualifying Agent_____________________________ Address______________________________________ City________________________ State______ Zip___________ Phone________________________________________ Email_______________________________________________ State Certification/Registration #_______________________________________________________________________ Architect_____________________________________ Phone____________________ Email______________________ Engineer_____________________________________ Phone____________________ Email_______________________ Workers Compensation Insurer ____________________________________ OR Exempt □ Expiration Date __________  Permittee declares that prior to filing this application they have ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches.  Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation, alteration or relocation of all, or any portion of said street or easement as determined by the Public Works Director, any or all said poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately removed from said street or easement or reset or relocated hereon as required by the Public Works Director and at the expense of the Permittee unless reimbursement is authorized.  All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the supervision of ____________________________________________________________________ (Project Superintendent) with (Company Name) ________________________________________________Phone_____________________________  All materials and equipment shall be subject to inspection by the Public Works Director.  All city property shall be restored to its original condition as far as practical, in keeping with City specifications and th e manner satisfactory to the City.  A sketch of plans covering details of this installation, as well as a copy of a recent survey shall be made a part of this permit. Calculations showing any increase in impervious area on owner’s lot or in the City right -of-way are to be included with this application.  The permittee shall commence actual construction in good faith within _______ days. If the beginning date is more than 60 days from date of permit approval then permittee must review the permit with the Public Works Director to make sure no changes have occurred in the area that would affect the permitted construction.  It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City’s right, title and interest in the land to be entered upon and used by the holder, and the holder will, at all times, assume all risk of and indemnify, defend and save harmless the City of Atlantic Beach from and against any and all loss, damage and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges.  The Public Works Director shall be notified 24 hours prior to starting work and again immediately upon completion. _______________________________________________________________________________ Date________________________ Permittee (signed in presence of Notary Public) STATE OF FLORIDA, COUNTY OF DUVAL The foregoing instrument was acknowledged this ___________ day of ________________________________________, 20 _________, by _______________________________________________________________________, who personally appeared before me and (printed name of Permittee) acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. __________________________________________________________ [ ] Personally Known Signature of Notary Public, State of Florida [ ] Produced Identification (Type) _______________________ 570-885-5770 570-885-5770 Homeowner None Amy Rutt None Atlantic Beach Amy Rutt Homeowner 88 Nicole Lane FL scse9000@aol.com 32233 ✔ 88 Nicole Lane, Atlantic Beach, Florida 32233 45 05/02/2023 May2nd 23 XXXX Texas Notarized online using audio-video communication Amy Lynn Rutt XXXXX XXXX Texas Harris DRIVER LICENSE