1303 Ocean Blvd RESO23-0059 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
BURGESS ROBERT CARTER 1303 OCEAN BLVD 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:
171835 0000 MANDALAY
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1303 OCEAN BLVD
RESIDENTIAL OTHER SINGLE OR
TWO FAMILY RESIDENTIAL
OTHER
Artificial Turf $2500.00
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: 6/26/2023
PERMIT NUMBER
RESO23-0059
ISSUED: 6/26/2023
EXPIRES: 12/23/2023
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: $125.00
3 PUBLIC WORKS DUMPSTERS/ROLL-OFF CONTAINERS INFORMATIONAL
Notes:
Dumpsters and roll-off containers must be used in compliance with Section 16-8 and must comply with all standards, per City code.
4 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration, including sod, is required.
5 PUBLIC WORKS CONSTRUCTION SITE MANAGEMENT INFORMATIONAL
Notes:
Provide construction site management plan, including location of silt fence, dumpster, portable toilet. Right-of-Way Permit is required if using right-of-
way for construction parking.
6 PUBLIC WORKS GRASS INFORMATIONAL
Notes:
Full site to be grassed.
7 PUBLIC WORKS REVISION INFORMATIONAL
Notes:
Any plan change must be submitted as a Revision to the Building Department.
8 PUBLIC WORKS DEBRIS REMOVED INFORMATIONAL
Notes:
All construction debris must be removed from job site by Contractor.
9 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
10 PUBLIC WORKS OTHER PUBLIC WORKS CONDITION INFORMATIONAL
Notes:
Must have base inspection prior to artificial turf installation. Contact Inspection Line (247-5814) to request Inspection.
2 of 2Issued Date: 6/26/2023
PERMIT NUMBER
RESO23-0059
ISSUED: 6/26/2023
EXPIRES: 12/23/2023
RESIDENTIAL OTHER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
r Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
9.)
1.
IS REQUIRED.
15 x
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: 1303 OGc41J `1(vvd /Permit Number: f,SU2-3-91
Legal Description Or 3/G4 j11U4ndA/A/ RE# IT/ 9.3.5--- 0000
X000
0
Valuation of Work(Replacement Cost)$ 2.s 0® `' Heated/Cooled SF I JA Non-Heated/Cooled 10
Class of Work: NewIAddition 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: 4104,A t
AL1 /VI-7, . rr4f/N,s70c/,c7 dd/f 11°CI-5a,f>- fiti/ ry,e..SuPeeti.) r%o )
Florida Product Approval# ,/Vo%i4 Vie///V511 for multiple products use product approval form
Property Owner Information
Name Ani/- .6bcpass Address i.?es .066-.4/7 8/(/'C
City Q I1./SG f/ State Zip .3 2_Z,3.3 Phone (7 7) .,,f- 53-/r
E-Mail Aur ge,S5q tt/^ie e @ 3f)A//• 6d 077
Owner or Agent{If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company SeLfri6 f/0) 72ii2i' Qualifying Agent
Address )O;2--PiA/ .5r- CitymproA.e 8/,y. State ci Zip JxZ64.
Office Phone 9pyr gee 911/7 Job Site Contact Number ,S,Q/oe
State Certification/Registration# /r/ A E-Mail 7`de4 ,ci:vi" 4tojeAl i/1 * l/v
Architect Name&Phone# /1/ J
Engineer's Name&Phone# /,,/e
Workers Compensation Insurer /5;1,64 OR Exempt Expiration Date , —..‹.--13
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 O -R15' a PERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDEOO' AN A ' NEY BEFORE
RECORD G Y UR O E F O ENCEMENT.
Signature of Owner or Age t)Sig :ture of Contractor)
Signed and sworn to(or affirmed)before me this 23 day of Signed and sworn to(or affirmed)before me this 23 day of
I ,
1-01-; ,by Rnfi)ln rcj e.s Z{23 , by TudO krbl4Mal
S- re of
iA`'f Y P`' •: VANESSA ANGERS
s: - :*_ MY COMMISSION#HH 244118 a`•""•` r VANESSA ANGERS
Personally Known OR ;;,t7Q vjPersonally Known OR a . .
F ...•,, EXPIRES:March 23,2026 a MY COMMISSION#HH 244118VProducedIdentificatior "°F.`' Produced Identification r.:a
Type of Identification:no" EXPIRES:March 23,2026
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NOTES:.
THIS IS A TOPOGRAPHIC SURVEY 1MTH TREEINV.E..6.97 INV.W 6.2
INV.W.-6.07
INV.W.-z2o
x9.40 ,88.54 ao.o6 LOCATION.m.21 40' RIGHT OF WAY
PAVED PUBUC ROAD 2. BOUNDARY DATA SHOWN AS PER SURVEY
BY THIS FIRM UNDER WORK ORDER No.
13
9.06
9.36
B 7 2017-0460.
AN
BENCH MARK:GET
000E Cr 3. NORTH PROTRACTED FROM PLAT.
P
6.,a
PEA
VVEMET'
ATOR-60
4. INTERIOR ANGLES ARE AS FOLLOWS:
N.A.V.D.1988 9.36 A:89'33'58"
B:9019'09"
6.83 C:90'49'39"
9.24 D:891714"
5. NO BUILDING RESTRICTION UNES PER PLAT.
6. BENCH MARK AS SHOWN HEREON WAS
ESTABUSHED BY GPS OBSERVATIONS USING
SPECTRA PRECISION EPOCH 80 RUNNING
NIMBLE VRS SOFTWARE IN N.A.V.D. 1988
DATUM.
7. FFE DENOTES FINISHED FLOOR ELEVATION.
THIS SURVEY WAS MADE FOR THE BENEFIT
NE PROPERTY SHOWN HEREON LIES IN
OF ROBERT CARTER BURGESS and
ANTOINETTE BURGESS.
FLOOD ZONE "X" (AREA OUTSIDE OF THE
0.2% ANNUAL CHANCE FLOODPLAIN) AS
WELL AS CAN BE DETERMINED FROM THE
FLOOD INSURANCE RATE MAP No.
12031C0409H, REVISED JUNE 3, 2013 FOR
DUVAL COUNTY, FLORIDA.
DONN W. BOATWRIGHT, P.S.M.
NOT VALID WITHOUT THE sKauTtmE Acro THE oRalAl
FLORIDA UC. SURVEYOR and MAPPER No. LS 3295
SEAL OF A FLORIDA LICENSED SURVEYOR AND NAPPER." FLORIDA LIC. SURVEYING k MAPPING BUSINESS No. LB 3672
CHECKED BY: BOATWRIGHT LAND SURVEYORS, INC. DATE
DRAWN BY: sWC
OCTOBER 5, 2020
FILE: 2020-1222 1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 241-8550 SHEET 1 OF 1