1515 Beach Ave RESO23-0062 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
CARRIERE WILLIAM L 1515 BEACH AV ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
SOUTHERN TURF 102 PINE ST NEPTUNE BEACH FL 32266
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170309 0000 ATLANTIC BCH HOTEL
RESER
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1515 BEACH AVE
RESIDENTIAL OTHER SINGLE OR
TWO FAMILY RESIDENTIAL
OTHER
Artificial Turf $2400.00
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.
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: 6/20/2023
PERMIT NUMBER
RESO23-0062
ISSUED: 6/20/2023
EXPIRES: 12/17/2023
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
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00
TOTAL: $125.00
2 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
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 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.
5 PUBLIC WORKS GRASS INFORMATIONAL
Notes:
Full site to be grassed.
6 PUBLIC WORKS REVISION INFORMATIONAL
Notes:
Any plan change must be submitted as a Revision to the Building Department.
7 PUBLIC WORKS DEBRIS REMOVED INFORMATIONAL
Notes:
All construction debris must be removed from job site by Contractor.
8 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
9 PUBLIC WORKS OTHER PUBLIC WORKS CONDITION INFORMATIONAL
Notes:
Must have base inspected prior to artificial turf installation. Must submit receipt of artificial turf material being used at final inspection.
2 of 2Issued Date: 6/20/2023
PERMIT NUMBER
RESO23-0062
ISSUED: 6/20/2023
EXPIRES: 12/17/2023
RESIDENTIAL OTHER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
S Building Permit Application Updated 10/9/18
r,
City of Atlantic Beach Building Department ALL INFORMATION
l 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
J=`r
IS REQUIRED.Phone:/
J (
904) 247-58 2f6 Em'`aiil: Building-Dept@coab.us
r
Job Address: J 8kM//
w/
AVG Permit Number: 2-3C'QC 2
Legal Description tor2JL/JNUs 6y/Nj /y`/ ,jJt 62 RE# 17O3b9— O0UD
Valuation of Work(Replacement Cost)$6, / Heated/Cooled SF Non-Heated/Cooled .....--
Class of Work: New Addition yAlteration Repair Move Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial E esidential
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: va_r &t o é b 1
A kri plc i,t IbILir 1,051,4/,J7/L 1 1 Zoo 'Q•it'• SuDie/'AA-1'U'"A I
Florida Product Approval# N1* for multiple products use product approval form
PropertyIAAOwner Informati
r
Name Wi IIiA01 C,urIfl•et'Address /SL( ot1G1j At/4
City
Stateg
Zip Phone yd y.. ,s yf. Z3 y9
E-Mail L// /ISM A 07 2 , V 61ao. (o
Owner or Agent(If Agent, Power of Attorney or ncy Letter Required)
Contractor Information '.
G er1
Name of Co pant, 0 1 €Y1- j J Qualifying A ent
Address t O L- q )S City i State r t Zip 3 7..7 „L
Office Phone 16 Y ' j
u /
71 Job Site Contact Number
State Certification/Registration# E-Mail a . ,
Architect Name&Phone# /7//4
Engineer's Name&Phone# 11 A
Workers Compensation Insurer i h tyk_ OR Exempt o Expiration Date s--" 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 COMM. NCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR P'OPE• . IF YOU INTEND
TO OBTAI FIN ANG, e SULT WITH YOUR LENDER OR A i A TTORN. BEFORE
RECO OT CE O• COMMENCEMENT.
Ai
Signature of Owner or Agent Signature of Contractor)
Sig -d a.. sworn to(or affirmed)
Abefore
me this ZC day of Signed and sworn to(or affirmed)before m-, his l'7{day of
itA . 20/S ,by U/,(t((l ,, Mat/nirrt/ at/ , 1102S ,by • a(t - .L Krthui
yy
Signa ure of Notary)
VANESSA ANGERS r'
ersonall Known OR .-,
MY COMMISSION#HH 244110 VANESSA ANGERS
yr
y
E oP° EXPIRES:Marg 23,2026 ["'
2rsonally Known OR I:4, " :.: MY COMMISSION#HH 244118r:f. '' Produced Identification -^'w`o;Produced Identificatiol
EXPIRES:MarchfR°P` 23,2026TypeofIdentification: Type of Identification:
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