1600 LINKSIDE DR DWAY23-0042 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
BEATRICE VELEZ 1010 MARVONE LN NEPTUNE BEACH FL 32266
COMPANY:ADDRESS:CITY:STATE:ZIP:
KETTELL INC.1860 MAYPORT RD ATLANTIC BEACH FL 32233
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
172374 6315 SELVA LINKSIDE UNIT 02
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1600 LINKSIDE DR DRIVEWAY SINGLE OR TWO
FAMILY DRIVEWAY
Replace concrete driveway
with brick pavers $11500.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 PUBLIC UTILITIES UNDERGROUND WATER SEWER UTILITIES INFORMATIONAL
Notes:
Avoid damage to underground water and sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is
needed, call 247-5878. State Law requires calling Sunshine 811 to have ALL public utilities located BEFORE beginning the work.
2 PUBLIC UTILITIES ADDITIONAL COMMENTS PUBLIC UTILITIES INFORMATIONAL
Notes:
See Revocable Encroachment Agreement regarding driveways/pavers and public utilities in the ROW
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 3Issued Date: 8/18/2023
PERMIT NUMBER
DWAY23-0042
ISSUED: 8/18/2023
EXPIRES: 2/14/2024
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
3 PUBLIC WORKS DRIVEWAY APRON INFORMATIONAL
Notes:
All concrete driveway aprons must be 5 inches thick, 4000 psi, with fibermesh from edge of pavement to the property line. Reinforcing rods or mesh are
not allowed in the City right-of-way.
4 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.
5 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.
6 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration, including sod, is required.
7 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.
8 PUBLIC WORKS SLAB DRIVEWAY REMOVAL INFORMATIONAL
Notes:
Slab and driveway to be fully removed.
9 PUBLIC WORKS MAXIMUM DRIVEWAY INFORMATIONAL
Notes:
Maximum driveway width within the City right-of-way is 20 feet.
10 PUBLIC WORKS GRASS INFORMATIONAL
Notes:
Full site to be grassed.
11 PUBLIC WORKS REVISION INFORMATIONAL
Notes:
Any plan change must be submitted as a Revision to the Building Department.
12 PUBLIC WORKS DEBRIS REMOVED INFORMATIONAL
Notes:
All construction debris must be removed from job site by Contractor.
13 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
2 of 3Issued Date: 8/18/2023
PERMIT NUMBER
DWAY23-0042
ISSUED: 8/18/2023
EXPIRES: 2/14/2024
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PU REVIEW BUILDING MOD OR ROW 001-0000-329-1007 0 $25.00
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: $150.00
3 of 3Issued Date: 8/18/2023
PERMIT NUMBER
DWAY23-0042
ISSUED: 8/18/2023
EXPIRES: 2/14/2024
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
i' T'kip Building Permit Application
sr Updated 10/ 9/ 18 ALL INFORMATION
City of Atlantic Beach Building Department HIGHLIGHTED IN GRAY
IS REQUIRED.
800 Seminole Road, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: I to 00 nIK51(/CL Permit Number: 1)V\•' " 23 '-{-\ \4
Legal Description 6 vit ai<SIL6- Ut L0 11/3 RE# t Z 3 -1(-/' 6 i /s
Valuation of Work(Replacement Cost)$ ((# SOO Heated/Cooled SF Non-Heated/Cooled
Class of Work: New Addition *Iteration' Repair Move Demo Pool Window/Door
Use of existing/proposed structure(s): CommercialResidential
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:
r
I la 1 C , -eA.}. q/Ve r-
l j
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name \
yrAddress /0I r (Yvo
City State F L Zip 37?('4, Phone
E-Mail I3P VLbj2
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company I1.n'
l€1/, _L- t Qualifying Agent / k f c tk.M
Address IR/0 P"1& por4 d City a3 State rL Zip 322 3 3
Office Phone cTa t/ 3-1't 127 G Job Site Contact Number k'>/ 90'/ 3 7 J /ee.W•
State Certification/Registration# E-Mail i r1to @ // -J/.//,'n t • (a/I--
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer l t Sfi` OR
Exempt o Expiration Date 1/3x/7 ?
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
UR
x
F 040# ENT.
Signature of 0 •ner or Ak t)
Signed and sworn to(or affirmed) before me this 7 day of
A]illij , 202-3 ,by i,ecc-}-r-1 C e Vici-ez
ignature of N t`sl
40'. ': VANESSA ANGERS
MY COMMISSION#HH 244118
ersonally Known OR Fo. $. EXPIRES:March 23,2026
Produced Identification, 0 l'
Type of Identificatig
r'
Signature of Contractor)
Signed and sworn to(or affirmed)before me this 1-7 day of
lidy , b?- ' ,by k,\, k—sc-v
4-v bi--• . t Nt
TABITHA MESHAW
pspr's 1 Notary Public-State of Florida
c Commission # HH 22744
Personally Known OR +1y: My Commission Expires
1,,,i0 July 22, 2024ProducedIdentification
Type of Identification:
s 41/2, RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION ALL INFORMATIONtCityofAtlanticBeachHIGHLIGHTEDINGRAY IS
800 Seminole Road,Atlantic Beach, FL 32233 REQUIRED.
u; o'
v
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address /600 (i'1 k Sf - i\/e._ Permit Number NO 2- -off-T 2-
Contractor Information
Company fly l'' I I 11;()C , Qualifying Agent
Address L/ . • _ CitY3 State FL Zip 37233
Phone Email in ro 6 1//,'r, C •
State Certification/Registration#
Architect Phone Email
Engineer Phone Email
Workers Compensation Insurer} S OR Exempt Expiration Date (i 3v/1
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 X,/l*/ Project Superintendent)
with(Company Name) 111jA-+e4/ , ',r,_. Phone qa t/ 3 7 7 /')c 8'
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 the
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 ( 0 0 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 Pu Ii Works Director shall_be notified 24 hours prior to starting work and again immediately upon completion.
Date 7/2 7/73
Permittee signed in presence of Notary Public)
STATE OF FLORIDA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this Z 1 r
day of I 20
1,47)
by k, -e_ p 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) MESHAW
o`4 p"'% of Florida
r`i" `,; Notary Public-StateCommission0HH 22744
jF My Commission Expires
July 22, 2024
S
REVOCABLE ENCROACHMENT AGREEMENT ALL INFORMATION
rs ; en City of Atlantic Beach HIGHLIGHTED IN GRAY
800 Seminole Road, Atlantic Beach, FL 32233 IS REQUIRED.
r-rrtl9
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
SV-eA i7 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 asI r P-00/6?beyr IN/ % 1 V 1 Any facility
maintained, repaired, erected, and/or installed in the ekerc 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
it/address 0 ' i orst (.s-AL , /II{,f vt Getat H L 1-2-7G6.
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 tbe CITY and its officers and employees shall be saved harmless by the USER from any of the
wo -rein under -rm if this permit and that all of said liabilities are hereby assu ed by the USER.
4161111.0. F Date g i` , Property
Owner/.,:,nt(signed in presence of Not.rublic)
STATE OF FLORIDA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this '7 day of >cvqs't 20 Z= ,
i
by Bee' t-rnCe \/Q. 1 2— who personally appeared before me and
printed name of Signer) acknowledged that he/she signed the instrument voluntarily for the
purpose express
Department Approval:
Sign. reof Notary Public, State of Florida
j Personally Known
a`•• •, VANESSA ANGERS
Produced Identification (Type){`"L L i(_- f,. =„=„ MY COMMISSION#HH 244118 I Scott Williams, Public Works Director
i`
f....`oP,. EXPIRES:March 23,2026
S=1P1-!TREE & VEGETATION AFFIDAVIT
FOR INTERNALOFFICE USE ONLY
s%' PERMIT#
City of Atlantic BeachV '23p'Z
j Community Development Department
800 Seminole Road Atlantic Beach,FL 32233
P)904-247-58002
4/0
ADDRESS // QQ L1ksth :DhvL
SUBDIVISION
G 1(
15i
o LOT /(/3eilçrted
RE# (72 )11,1-6 3 /s---f570L---S-ITE—NTIAL 3 COMMERCIAL OTHER
APPLICANT INFORMATION
NAMESP4-1— .V- 2 ---PHONE#
fes
ADDRESS CELL#
CITY STATE ZIP CODE
EMAIL 2 "J)V Gm
seu1 '
ur • I
C]OWNER LEGAL AUTHORIZED AGENT
I affirm that I have reviewed the provisions ofChapter 23,"Protection ofTrees and Native Vegetation",of the Municipal Code ofOrdinances for the City ofAtlantic
Beach Florida and/or I have participated in a preapplication meeting with the Administrator ofthose regulations.Subsequently,I affirm that no regulated trees and
no regulated vegetation will be damaged,destroyed and/or removed from the above-described property and/or adjacent properties including right of way.
HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT: Signature of Property Owner(s)or
Authorized Agent
SIGN OF , ' A PRINT OR TYPE NAME DATE
eat dee Vele- a -;-,--
Coun of Lv 441 Gt Q -P>v vs+' 2OZ3
Identification verified: ft kg L
4B-PPa i'CLe- UQ 1,-L--
Oath Sworn: [3 Yes No
s"`!4iE•.. VANESSA ANGERS moi'
MY COMMISSION#HH 244118 Notary Sir•; r-
EXPIRES:March 23,2026
ifS My Commission expires 3i2-12.0'7,‘,
04 TREEAND VEGETATION VIT03.07.2018
FFIDA
CITY OF ATLANTIC BEACH
A ) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
904) 247-5800
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 I ('OC)Ur)ks;067
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ADDRESS: 1 600 LINKSIDE DRIVE GRADE TYPE: A
COMMUNITY: SE LVA LINKSIDE SOD: 6052 Sq.Ft.
LOT: 143 UNIT 2 12 PALLETS
DWG.: 1 43S L2.DWG FENCE: 214 entex Homes IIDATE: 08/18/93 FLATWK: 932
I DRAWN BY:A.J.B. FNDTN. TYPE: MONO t
NORTH FLORIDA DIVISION
i SCALE: 1"= 20.00'
I
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $150.00
DWAY23-0042 Address: 1600 LINKSIDE DR APN: 172374 6315 $150.00
PUBLIC UTILITIES PLAN REVIEW $25.00
PU REVIEW BUILDING MOD OR ROW 001-0000-329-1007 0 $25.00
PUBLIC WORKS PLAN REVIEW $25.00
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
ZONING PLAN REVIEW $100.00
ZONING REVIEW SINGLE AND TWO FAMILY
USES 001-0000-329-1003 0 $100.00
TOTAL FEES PAID BY RECEIPT: R24350 $150.00
Printed: Friday, August 18, 2023 1:29 PM
Date Paid: Friday, August 18, 2023
Paid By: BEATRICE VELEZ
Pay Method: CREDIT CARD 1141522218
1 of 1
Cashier: TG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R24350