1771 Beach Ave ACC19-0008 COAB Permit Form with Conditions - RenewedOWNER:ADDRESS:CITY:STATE:ZIP:
TRAGER MITCHELL 1771 BEACH AVE ATLANTIC BEACH FL 32233-5838
COMPANY:ADDRESS:CITY:STATE:ZIP:
MCANENY BUILDERS LLC 1010 EAST ADAMS ST JACKSONVILLE FL 32202
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169675 0000 NORTH ATLANTIC BCH
UNIT 1
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1771 BEACH AVE
RESIDENTIAL OTHER SINGLE OR
TWO FAMILY RESIDENTIAL
OTHER
OUTSIDE WOODEN DECK -
Renewed $12500.00
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: 3/4/2019
PERMIT NUMBER
ACC19-0008
ISSUED: 3/4/2019
EXPIRES: 4/27/2024
RESIDENTIAL OTHER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $115.00
BUILDING PERMIT RENEWAL 455-0000-322-1000 0 $110.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $57.50
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.59
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $50.00
TOTAL: $362.09
2 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
3 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL
Notes:
Roll off container company must be on City approved list (Advanced Disposal, Realco Recycling, Shapells, Inc., Republic Services, Donovan Dumpsters,
Phillips Containers, JDog/Dennis Junk Removal, All American Roll Off, WCA Waste Corporation). Container cannot be placed on City right-of-way.
4 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration, including sod, is required.
5 PUBLIC WORKS RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
6 PUBLIC WORKS DECKING REMOVED INFORMATIONAL
Notes:
All old decking must be removed from job site by Contractor.
2 of 2Issued Date: 3/4/2019
PERMIT NUMBER
ACC19-0008
ISSUED: 3/4/2019
EXPIRES: 4/27/2024
RESIDENTIAL OTHER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
i'
rt_IVJ ;+ City of Atlantic Beach APPLICATION NUMBER
6 Building Department To be assigned by the Building Department.)
800 Seminole Road j1 Q_o _ ooAtlanticBeach, Florida 32233-5445 J,_' v
Phone(904)247-5826• Fax(904)247-5845 7
x!+Jiil' E-mail: building-dept@coab.us Date routed: L l
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 7 7 l r` , f Department review required Yes No
Buifdin '
n(
Applicant: ,
C!`
t--)GADy U l LDE LS Planning &Zoning
Tree- ministrator
Project:C_) L—C_K _o D is Works
u6Tic Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required
Review or Receipt
Date
of Permit Verified B
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Rp roved. Denied. Not applicable
Circle one.) Comments:
BUILDI
PLANNING &ZONING
Reviewed by:Date: 012-61261_7
TREE ADMIN.
Second Review: A roved as revised.pp Denied. Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:Date:
FIRE SERVICES ; Third Review: Approved as revised. Denied. Not applicable
Comments:
i
Reviewed by:Date:
Revised 05/19/2017
1y'%
Building Permit Application OFFICE COPY Updated 10/9/18
ry_
City of Atlantic Beach Building Department ALL INFORMATION
v
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
of31
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address:71 AVC Permit Number: I`1 CC.( 00c)
Legal Description 1L6r 3G ri AnAdx,c t5k ArIJ i-r II RE#
Valuation of Work(Replacement Cost)$_17, SdQ Heated/Cooled SF Non-Heated/Cooled
r
Class of Work: New Addition Alteration 41 epair Move Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial 2 Residential
If an existing structure,is a fire sprinkler system installed?: Yes Ao
Will trees be removed in association with proposed ro'ect? Dyes must submit separate Tree Removal Permit) ixo
Describe in detail the type of work to be performed:tMat1,665i, aF*ro oa
A P2oit. lyX ZO' '(4 otLE N 'TILE RAiP T rST S&S`F M- . 7,,,t0 5A+h4 acZbA Prc ID
L c t ks- Lt ke-
Florida Product Approval# for multiple products use product approval form
PropertV Owner Information
Name M i TG•( 43 FQ,p,46 TZ Address 1:7*7 1
City AL LA gm c !`(%cJA State r_Zip 3 Z Z- 33 Phone 9 p L(- 5711 — 9030
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company-tel LAy(k_tJ 4 rgu t('b" LLL_ Qualifying Agent Ly—OwAn IY t YaaV,VIJy
Address p 1L city3WI IC State sZip3226H
Office Phone Job Site Contact Number ( OA)i 7,1k- ^.(4
State Certification/Registration# E-Mail.VIF ((Ir A1VAM Q C(/
Architect Name&Phone# 0 4
Engineer's Name&Phone# 1A
Workers Compensation Insurer hUI CD OR Exempt Expiration Date 7i0
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or instal ation 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 ORNEY BEFORE
RECO G YOUR NOTI OF COMMENCEMENT.
Signature of Owner or gent)
Sig2ftirmed)
of Contractor)
Signed and sworn to(or affirmed)before me this day of Si ned and sworn to(or before
C1
Signature
day of
by L( Gr I.a by VC M
Signature of Notary) Signature of Notary)
ti"*.: MILDRED REYES MORENO tiSY' MILDRED REYES MORENOvfPersonal) v Known 0 c MY COMMISSION#FF905780 [ ersonally Known OR
Produced Identificat of Produced Identification MY COMMISSION#FF905780
Tyre of Identification:
EXPIRES August 03.2118
i EXPIRES August 03,2019ofIdentification:
4071 M-0'53 FloridallourySrvim.com
Army / -t- ,0CC/9'-0008'
NOTICE OF COMMENCEMENT OFFICE COPY
State of &44T)f Tax Folio No.
County of XyAt—
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713
of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: LoT :i 2 pn-wTic s uur- I
Address of property being improved: I I RL!1 P 1F_•l S
General description of improvements: rrl l
iy Vzo (;S-g o-
p("
c. AND mis 515, y= ry1 : L3u'IL;2 m A c>G 3 fid
Owner:fCR -3 '9 VeAI '(Fu. Address: gF O AVE. AAj"VIC_ L 32235
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
n A Name:
Contractor:
Address:- (46P VW-Y,
Telephone No.: OEM) v-AA- Fax No 1T j
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may
be served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b), Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Doc#2019036120,OR BK 18691 Page 522, Signed: Date:'—eh 0 tq
Number Pages:1 Before me this day of the County of Duval,State
Recorded 02/13/2019 02:41 PM, Of Florida,has personally appeared V-
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Notary Public at Large,State of Florida,County of
COUNTY
My commission expires: S
Y`" M RED REYES MORENO
RECORDING $10.00
Personally Known: c MY COMMISSION R FF005M
Produced Identification: EXPIRES AUVal 0& 19
4071392-0`53 FbrfOanlpu yServte.co m
s
rs,a,y;City of Atlantic Beach APPLICATION NUMBER
Building Department To be assigned by the Building Department.)
r 800 Seminole Road
r., Atlantic Beach,Florida 32233-544541,
LCA ly a V
Phone(904)247-5826• Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: Z 1
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Department review required Yes No
n 6, olLpusApplicant: hi GA7y Planning &Zoning
Tree c ministrator
Project: picabW
4 1-dulic Utilities
Public Safety
Fire Services
Review fee $ Dept Signature 4 `
Other Agency Review or Permit Required
Review or Receipt
Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. Denied. Not applicable
Circle one.) Comments: /
BUILDING
PLANNING &ZONING
Reviewed by:IOAF— Date:1-1 5-- fC,
TREE ADMIN.
Second Review: A roved as revised.pp Denied. Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:Date:
FIRE SERVICES Third Review: Approved as revised. Denied. Not applicable
Comments:
Reviewed by:Date:
Revised 05/19/2017
i
rty1,`Jr City of Atlantic Beach APPLICATION NUMBER
Building Department To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 R oo V
Phone(904)247-5826• Fax(904)247-5845
E-mail: building-dept@coab.us L Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 7 Department review required Yes No
i din
Nanning &ZoningApplicant:
Tree minis rator
Project: F(K V r`l D Public W`- oaks
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required
Review or Receipt
Date
of Permit Verified By
Florida Dept.of Environmental Protection
yFloridaDept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. Denied. Not applicable
Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed b Date:
TREE ADMIN.
Second Review: Approved as revised. Denied. Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:Date:
FIRE SERVICES Third Review: Approved as revised. Denied. Not applicable
Comments:
Reviewed by:Date:
Revised 05/19/2017
City of Atlantic Beach ll,! APPLICATION NUMBER
Building Department To be assigned by the Building Department.)
800 Seminole Road FEB 15 2019AtlanticBeach, Florida 32233-5445 L l ' o C-) V
Phone(904)247-5826 • Fax(904)247-5845
U319 E-mail: building-dept@coab.us Date routed: l
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 7 l EGP,0_( Department review required Yes No
Applicant: NNCP tj&Qy ( 6L2iLC)CkS Planning &Zoning
I Cde'Administrator
Project:Q*, QQ D Public Works
ublic Utilities a
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required
Review or Receipt
Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: pproved. Denied. Not applicable
Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed Date
TREE ADMIN.
Second Review: A roved as revised.pp Denied. Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:Date:
FIRE SERVICES Third Review: []Approved as revised. Denied. Not applicable
Comments:
Reviewed by:Date:
Revised 05/19/2017
Building Permit Application Updated 101-9118
City of Atlantic Beach Building Department ALL INFORMATIONJN9800SeminoleRoad, Atlantic Beach/ FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address:-177-7 6&pjc-t M 4E Permit Number: e DOC)
Legal Description 1.6T- 34 N ATIAr%f{'iC RE#
Valuation of Work(Replacement Cost)$_J Z Q ° Heated/Cooled SF Non-Heated/Cooled
Class of Work: New Addition Alteration 5 epair Move Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial QResidential
If an existing structure,is a fire sprinkler system installed?: Yes Ei do
Will trees be removed in association with proposedproject?Yes must submit separate Tree Removal Permit) f;4
Describe in detail the type of work to be performed: —9,GrAO 04 ut5j t 534470.1-( 113g"LAIC!
J Z6,,po6
A-t>P20y . y x 20' t'3aolc4E N '(LC RN v ,s-rS s M- . R lit v 59",4 RNfl
c L=1 kd--- L k
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name M t TCS•{ 4 3471U-73Zc Yz -- Addres:>
City P Litt- ic- ISr-Ae-"State ELZip 3ZZ 2 ; _Phone 571 --ciolia
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company i LA Jf 0 4 LILC Qualifying Agent f(AWWAddressCQCDwtCityU( J Statert— _Zip32261{
Office Phone Job Site Contact Number (t((i` 9-IR "
State Certification/Registration# C4,P, E-MailCt,(Vt
Architect Name&Phone# N/4
Engineer's Name&Phone# ri 1A
Workers Compensation Insurer V% 15VI OR Exempt Expiration Date 7iO
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or instal ation 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 ORNEY BEFORE
RECORMIG YOUR NOTI OF COMMENCEMENT.
Signature of Owner or gent)Signat of Contractor)
Signed and sworn to(or affirmed)before me this day of Si ned and sworn to(or fir ed) before me this day of
j[,by LL (jV pl c a l,by9
Signature of Notary) Signature of Notary)
MILDRED REYES MORENO MILDRED REYES MORENOk:Personally Known 0 :+?'- , ersonally Known ORMYCOMMISSION#;:F905780 MY COMMISSION#FF905780ProducedIdentificato1 . Produced Identification
o:-EXPIRES A Lk 03,2019
Type of Identification: Type of Identification: aL EXPIRES August 03,2019
J3---priOZKvacay3ervicewm----- 1407139E-0'53 FrDridaNUaaryService.com
Vit.
WAO I L L
YIWJJY
I.z madgrI as 3Op:) &Us
71:
a3nva M/> ,sz
I'H]
VIS uniW73.1 WnN'BTJY1
HOV39J91 :MHM' MML XVM'(NV 1,VMOVOH I{OVOHddV 3EJVHVP 1."IH3wa0d 1
M3 ,-MU00 cm 2irwi. V 3nN nd
9AM 3FiaL NI NVM SV
L NOId,V2ocwoO 3ONV ns ZZ'OS a781j'M.. ...SZo50'NI
XMM NOSJVM SM(MVH i 90'09 'M„00,L5 o b2'O
0'N 1
p 1.
d QH
OZ
L QI. .t$SJHHJ h4331I3f-1 I
r---
o-t::s,,•,.:,:,:.... .i,
pla pxd
e.
dYo ON 30x7,1•YYN Doom y , 2'0 5 tr '!k::fi
d'1,I•aHd
9D I SA
f' 7pItl0 `r •
313NONOO Hpap
m
ANOOIYY NOOO d IAY9 5•-
I•
ILLI
30NROIS38
a „arca luvu ac)wura4i3Wt1»3+N012i9
79 NVJ SV 7`MM W ,.3A. G'
1.a01S-Z
3(IIS.im VSHV) rXr 3NOZ D 11VM HO0.1r
10-1 NMOHS AWadOdd WU
r.0
CD
AN00'tYBli W2 „ N
NOYOd ON00 1J 1-4
mm
I (Q
Q ••''
y g
4
b ONQ ,•:'
OOM 0 1H3NOx01!bN0
I 49 rn y I
f9D b I
bo
Z
IrCD 03tl3A00 r
y
m it v GGr•
asole
0
A
rn I
A) 231VVA LN013H)
ON]/AOYAItld 000111 m h
E IM
a
Im
I-
3NIl H0V813S N0110naisN00 to
7x1'1 x030 H71- IVIS,NO 03SVO SO(VIVv38 c131d 1g
IV-'Id Had SV'I'H•B4ON
I N
r• aV'td 3P sv sa,NIN"v3e
kaAWS caVON668 V Si sihi I`” t"`';"
92 io-i W N L9- .I of S31ON I
7ON3i iNIM I
3N1'1 N0V813S NO110f1H1SNOD
9V16V00
05,3 91,IGo60'S
11'ZS£ °91,ISoba'S
o 2•p
8Seb0'S Il o0'21
I ro oo,ol•60•x
tr b'ON 1N3H0NON a tl.y;.t:;... ,..:n •.
UNO 0Nf10>f P
01Ol
3NI'1-I081N00 NOISOH3
219C'0"I Arid
fir . L811 f`d•brQ,S HONI„2/113P
219f0"17d1d .pp71.117
NOMI„2/I AAS