647 Selva Lakes Cir DWAY23-0047 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
TORRES JONATHAN 647 SELVA LAKES CIR ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
CORNERSTONE SOLUTION
HOME AND BUSINESS I 5154 W Edward St JACKSONVILLE FL 32254
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
172027 5900 SELVA LAKES UNIT 03
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
647 SELVA LAKES CIR DRIVEWAY SINGLE OR TWO
FAMILY DRIVEWAY
Remove driveway and put
pavers $9380.00
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: 10/25/2023
PERMIT NUMBER
DWAY23-0047
ISSUED: 10/25/2023
EXPIRES: 4/22/2024
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
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. Proposed driveway must match existing driveway.
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: 10/25/2023
PERMIT NUMBER
DWAY23-0047
ISSUED: 10/25/2023
EXPIRES: 4/22/2024
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
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
14 PUBLIC WORKS IMPERVIOUS AREA INFORMATIONAL
Notes:
No additional impervious square footage area can be added to this property.
15 PUBLIC WORKS OTHER PUBLIC WORKS CONDITION INFORMATIONAL
Notes:
Per Contractor on Revision submittal: Just replace existing concrete driveway and walkway pavers. No added sqft. No extension.
3 of 3Issued Date: 10/25/2023
PERMIT NUMBER
DWAY23-0047
ISSUED: 10/25/2023
EXPIRES: 4/22/2024
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
fir-'`'
0111EY
BUILDING PERMIT APPLICATION
FON
INTERNAL
OfFICEUSf
F
WAc 2'City of Atlantic Beach Building Department
PERMIT#
tract w
Process
z Y
8pp Seminole Road,Atlantic Beach,FL 32233
ALL,nforrnat'nn req
Phone:(904 t
Job Ad:ress
247-5326 Email:Building Ucl>lL'cu•'I' r''
REM t 2k-2'--P------
Legal escription ` , /
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Goofed SF
Valuation of Work p
Non
Re tacement Cost a Heated/Goofed SF
Poof
Window/DpOr
Class of Work: 0 New Addition teration []Repair Move Demo
Use of existin Proposed structures) - Commercial esidenti,a__l-.,,((
oIfanexistingstructure,is a fire sprinkler system installed?: DYes L1errO Tree Ftemol Perrmrt)
Witt trees)be removed in association with proposed project?
Dyes(Must submit separate
Descripe in detail the type of work to be performed:
r val InformationSheet)
For multiple
products use Product AApp o
A tt:N- q0FloridaProductApproval# D
Phone I
Property Owner Information Name .v - ..illi o 5q------------
Email
l
State P
Address b-"1- Cie: _ p [, ___V city 1f
Emai, JI Ow er or Agent(If A ent,Power of Attorney or Agency letter Required)1'r C e 1c57hrMr•'7s av o
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Contractor Information Name of Company , -_ 111 • • ' • •
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5 A ,--------j,State Zip Z
Address
City \ t-rL_---
State Certification/Reg istraiion#
Email a 4 p • 'r, fi -
Qualifying Agent
4, v Job Site Contact Number
OR Exempt (]
Expiration Date ) } ( 7/
Worker's Compensation Insurer r'Z -C1-Cc>l t Z —
Phone
Email
Architect's Name Phone
Email
Engineer's Nameo
Application is hereby made to obtain a permit to do the work and installations as intmeetd.t certify
standards
that
of
work
olaws
tagutio nhas
commenced prior to the issuance of a permit and that all work will be performed
construction in this jurisdiction.I unerstand
undHEAand
that a separatee
AIRpermitCONDITIONERS,
must be
secureted for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,operty that mc
NOTICE:In additionpu the requirementshs county,
ondrmit,
there moy be additional
here may be additional permits
requons
ired fromoother governmentaltal entities
be found in the public ratasuch 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 applicabt
laws regulating construction and zoning.MAY RESULT IN
IMPROVEMENTS TOYOUR PROPERTY. INTENDFYOU TO OBTAIN FINANCING,,
COU PAVING TWICE
CONSULT OWITH
FOR
COMMENCEMENT
OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Owner or Agent}
Signature of Contractor)
Si• ed an, swo to(or affirmed)before me this .1S-}" day of Signed and sworn to to affirmed)before me this da
ff.- 70) by .'"'"
turreh by
Signature of Notary j " A rel Signature of Notary r
I j Personally Known OR xProduced Identification I j Personally known OR G roduced Identificatio
tJ/
Type of Identification p Type of Identification'fV •x1"
rr'••. THOMASMANUKIAN iiAi¢... EKATERINA BAKLUSHINA
NotaryPublic State of Florida c,
I ._. ,.-< • Notary Public•State of Florida I
Commission N HH 396103 a" <` Commission GG 984265 }
F-'' My Comm.Expires May 9,2027 cr n My Comm.Expires May 4,2024
REVOCABLE ENCROACHMENT AGREEMENT
ALL INFORMATION
City of Atlantic Beach
HIGHLIGHTED IN GRAY
5 800 Seminole Road,Atlantic Beach, FL 32233
IS REQUIRED.
REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation organized and
existing under 'the laws laws of(the Sta e of Florida, hereinafter referred to as "CITY" and
LO)20C-' F 1Jcl `J11 r jCCVW.ck 0(0.4 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 1 1-} { ct y(=1 i1jS.1(46c L &)
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 6 II 5(10 ` (I S C'w[IE A+LAAI-4Z
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 Ufl / /_/ ( 2o >
Property Owner/Agent (signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this /V day of Apto 20 .43
by TG rr Gcl 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
ersonally Known
Jjp,
Produced Identification (Type) U `"' ` e Public Works Department Date
Revision Date:05/09/2023 r7 4..• EKATEaINA BAKIUSHINA
4. dr Notary Public•State of Florida
L: 'Q Commission x GG 984265
of.i` ' My comm.Expires May 4,2024
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aa/(/Q,Q 1,CAf ,g42 3- 6- 9 7 NOTE POUNO 46' tO,V NEQS
HEREBY CERTIFY T)( T mks, IURVEY, PERFORMED UNDER MY RESPONSIBLE DIRECTION MEETS THE IlLEGEND:1!&A1 III Trruniirel cTAuna, 1E' wtianciipvcvrc ' sr-mon/oderWDIT1.a rweTTP Alat1.7_ n nA otns
Revision Request/Correction to Comments ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: INV At(2;-0047
Revision to Issued Permit OR 0-Corrections to CommentsDate: LO (o31 23
c
Project Address: 6 LA S LVA L pt v(fT CP- Af 4Z- 130'6-
I
Contractor/Contact Name: 1/V1/\ C0(1/At C EyLP\-)C cJ i'-'/U
Contact Phone: 904 S-23 4-:0 r;JlpEmail: .Q.S( ,CMC-Cc.6I)F--(t3 .Coeivi
Description of Proposed Revision/Corrections:
e)Q1?C()LCC- C N E AN v l t C ll.
Pczv(ec - Jo At,t)ceN SF - Jo C',r-SEN, k \
I KF\MAL ( rivliN) affirm the revision/correction to comments is inclusive of the proposed changes.
printed name)
Will proposed revision/corrections add additional square footage to original submittal?
t2-t`
No Yes (additional s.f. to be added:
Will proposed revision/corrections add additional increase in building value to original submittal?
No [_1*Yes (additional increase in building value:$" Contractor must sign if increase in valuation)
Signature of Contractor/Agent: Z/ L. / -1 C _
Office Use Only)
Approved Denied Not Applicable to Department Permit Fee Due $
Revision/Plan Review Comments
Department Review Required:
Building
Planning& Zoning Reviewed By
Tree Administrator
Public Works
Public Utilities
Public Safety Date
Fire Services Updated 10/17/18