2021 Vela Norte Cir DWAY23-0056 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
HERTEL STEPHEN R 1212 FINNEANS RUN ARNOLD MD 21012-1876
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:
169506 1106 SELVA NORTE UNIT 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
2021 VELA NORTE CIR DRIVEWAY SINGLE OR TWO
FAMILY DRIVEWAY
Replace driveway with brick
pavers $8800.00
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: 11/8/2023
PERMIT NUMBER
DWAY23-0056
ISSUED: 11/8/2023
EXPIRES: 5/6/2024
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
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 MAXIMUM DRIVEWAY INFORMATIONAL
Notes:
Maximum driveway width within the City right-of-way is 20 feet.
9 PUBLIC WORKS GRASS INFORMATIONAL
Notes:
Full site to be grassed.
10 PUBLIC WORKS REVISION INFORMATIONAL
Notes:
Any plan change must be submitted as a Revision to the Building Department.
11 PUBLIC WORKS DEBRIS REMOVED INFORMATIONAL
Notes:
All construction debris must be removed from job site by Contractor.
12 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
2 of 3Issued Date: 11/8/2023
PERMIT NUMBER
DWAY23-0056
ISSUED: 11/8/2023
EXPIRES: 5/6/2024
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00
TOTAL: $150.00
3 of 3Issued Date: 11/8/2023
PERMIT NUMBER
DWAY23-0056
ISSUED: 11/8/2023
EXPIRES: 5/6/2024
DRIVEWAY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
r.;., jBuilding Permit Application Updated 10/9/18
P,>
City of Atlantic Beach Building Department ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
19IS REQUIRED.
Phone:, (904) 247-5826 Email: Building-Dept@coab.us
7
Job Address: ( ilt UQAG Ah-i1 V'q it Permit Number: D bry A 1/4112; 01/q
Legal Description 3 —61 I1 0 q ---/ 5 KO SiI vt A44( 0 1 L,0'/ S.. RE# 16 gs72 -i/D 6
Valuation of Work(Replacement Cost)$ WC)Heated/Cooled SF Non-Heated/Cooled
Class of Work: New Addition 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),;LINo
Describe in detail the type of work to be performed:
r.
G c
air 6' J )firm k kw.,e/sP\P/0
Florida Product Approval #for multiple products use product approval form
Property Owner Information
Name 4.1..,r-Le I Address aU '1 \I e,IC. NC'(-4 f. Circ . >°
City A+ ( r4 i s 8 f Cu e k State F J— Zip 3 a :'QI 3 3 Phone `/ `/.3 a 5 L/ . 3 5 S L
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
L (..I I
Name of Company f f/II/( i 1 1 C• Qualifying Agent J'ce. ( . I I I
Address,t) 1 f O-cRe•t.ic( City A••}i,.r.i-4. c'C.A. State Ft Zip 32,Z33
Office Phone Job Site Contact Number
r, 6,State Certification/Registration # E-Mail in AQ I,.„ : CDM
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer A Try jt" OR Exempt D Expiration Date 9/3 t/zy
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 YOUR NOTICE OF COMMENCEMENT.
L t.t tet G -Z-/e—
Signature
Z//_k N
Si ature of Owner or Agent)Signature of Contractor)
t
Signed and sworn to(or affirmed)before me this I Ok day of Signed and sworn to(or affirmed)before me this `p day of
1 Octuber , ZU2 ,by eel Anv‘ . -er{ e J 7013 ,by IG-4C' kQ- •}-e-[
15.1111-rs f.Clo
k':••;
4"`i%•, LADAYUANICHOLS
VANESSA ANGERS 4 MYCOMMISSION#HH 226065
MY COMMISSION#HH 244118 o,-
Personally Known OR Personally Known OR ..';* •oP: EXPIRES:February 8,2026
EXPIRES:March 23,2026 9'`.•
A Produced Identification •'••E9!Produced Identification ,,:,,s,;v r-r.
Type of Identification: iL I ype of Identification:pV VGY5 Li Cev'
p.m , RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION ALL INFORMATION
City of Atlantic Beach HIGHLIGHTED IN GRAY IS
800 Seminole Road,Atlantic Beach, FL 32233 REQUIRED.
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
y 2tn4Xe) ` (:
Job Address 717 \k1 j(101- . i j./ . Permit Number
Contractor Information
Company Kettell, Inc. Qualifying Agent Kate Kettell
Address 1860 Mayport Road City Atlantic Beach State FL Zip 32233
Phone(904)372-7226 Email info@kettellinc.com
State Certification/Registration #
Architect Phone Email
Engineer Phone Email
Workers Compensation Insurer 11 AmTrust OR ExemptnExpiration Date 09/30/2024
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 Kyle Kettell Project Superintendent)
with(Company Name)
Kettell, Inc. Phone(904)377-1008
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
60 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 Public Works Director shalll benotified 24 hours prior to starting work and again immediately upon completion.
Date /O//o/Z3
Per ittee(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this i iJ day of C)( 20
by E k-e,'who personally appeared before me and
printed name of Permittee)
LADAYUANICHOLS
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
MYCOIAMISSIONtHH226065
EXPIRES:Febmary 8,2026
Amseiiiiiiiwaammansupseawassiapia
j Personally Known
Signa ure of Notary Public,State of Florida a J.Produced Identification(Type) L1Y\Vel \_!(1ST'
H:\Applications&Forms\Word Documents\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18
REVOCABLE ENCROACHMENT AGREEMENT
ALL INFORMATION3' City of Atlantic Beach
I 800 Seminole Road, Atlantic Beach, FL 32233
HIGHLIGHTED IN GRAY
IS REQUIRED.
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
Ifr .e, +RA 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 Dc)f/-P Lt_)(l/\., P-.121.4 6/717- ,j'1i
Any re aired and or installed'i? the excise of the privilege granted remains subject tofacilitymaintained, repaired, erected, /
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 Z O7-/c lb * / 6'/i l/
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.
k_AAL,. Date !4,'// G i2 L)z3
Property Owner/Agent (signed in presence of Notary Public)
STATE OF FLORIDA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this C
E'
day of Ch....-N 20 2-3 ,
by EE1`-1 N'V1r'1 -der+€_ who personally appeared before me and
printed name of Signer)
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
o •, Department Approval:
VANESSA ANGERS
Signatur- of Notary Public,State of Florida MY COMMISSION#HH244118 '
Q°• EXPIRES:March 23,2026
I Personally Known fbf F:
4/Produced Identification (Type) r:( r1., Scott Williams, Public Works Director
H:\Applications&Forms\Word Documents\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18
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CITY OF ATLANTIC BEACH
s 800 SEMINOLE ROADv
ATLANTIC BEACH,FL 32233
Ari J3i9 .
904)247-5800
SURVEY AGREEMENT
NOTICE
All new projects creating more than 250 Square Feet of impervious surface or requiring on-site storm waterretention, 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 neworiginaldocuments, 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 producedbythesurveyor.
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 theapplicant.
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 $110.00 Fee.
JOB ADDRESS 7,0
OWNER or CONTRACTOR (Print) k-e--1 9 H £r-1 £1
Signature _111_1-UA Date % Oh() 1°2 2 3
1
NOTICE OF COMMENCEMENT Q506—C)/
Permit No. Tax Folio No. (O
State of Florida,County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
0gr 1. D ription of property(legal description of rope and address if available):
t./ aq 7,5- 24 SeAva /Mica-€ urN t i L44- S3
a 0 2. General Description of improvements:
3. Owner Information:
8 v
l ` '
QZ A,/ ir Zak.3213ss: He4e4,ein I v u
C CC b)Interest in property:
016.` vcsic)Name and address of simple titleholder(if other than owner):
t`to (74
z 4. Contractor Information: i
a =
z O
a)Name and Address: Kettell.Inc. ( tit 0 ''Yl Ai P CKQ'4 g L,' M I 4 G B LA..
J
L 3D.2 33
1 9} b)Phone Number:(904)372-7226
8 6p 0 w 5. Surety Information:
o z v a)Name and Address:
b)Phone Number:
c)Amount of Bond:$
6. Lender Information:
a)Name and Address:
b)Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13(1)(a)7,Florida Statutes:
a)Name and Address:
b)Phone Numbers of Designated Person:
8. In addition to himself/herself,Owner designates of to receive a
copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes.
a)Name and Address:
b)Phone Number of person or entity designated by owner:
9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction
and final payment to the contractor,but will be one(1)year from the date of recording unless a different date is
specified:
WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE
OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION
713.13,FLORIDA STATUTES,AND CAN 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 COMMENCING WORK OR RECORDING YOUR NOTICE OF
COMMENCEMENT.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated
therein are true to the best of my knowledge and belief.
4}1;0 kte,l exde, Iowner
Signature of Owner or Authorized Officer/Director/Partner/Manager Signatory's P ' ted Name&Title/Office
The foregoing instrument was acknowledged before me by means of 6dphysical presence or online notarization,
this j day of (2>f1 20 23,by )<e2 k1 who is personally known to
Name of Person)
me or produced fL NYlVIeA( u(•2Y1Se as identification,as 'MIA e Ow vux-
J2
t `^I ' _J^ n'
Type of Authority,e.g..officer,attorney in fact,etc.)
for t J V e,14 7 ci
Name of Party Instrument was Executed for)
NOTARY IGNATU —STATE OF FLORIDA
Commissioned Notary Name: VOAse<561 A'Ytq..ek.1'
VANESSA ANGERS
J
i 8AMM bN ' 1244118
ae:• EXPIRES:March 23,2026 Revised 1/1/2020