246 MAGNOLIA ST DWAY23-0064 ;;s--L-i, BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
est'` City of Atlantic Beach Building Department
PERMIT# teto - OCOO
800 Seminole Road, Atlantic Beach, FL 32233
**ALL information required to process
\J � Phone: (904) 247-5826 Email: Buildin -Deg@csab.us
-Decoab.us
Job Address zei 6 M Ar,io j Gc
a 4-16,4i, ,&€a , f 3a•a.3 3 RE# t t p01 2 3-o 06'-
Legal Description — /6 - e.t.3 c)-4) C
Valuation of Work(Replacement Cost) 34ct k Heated/Cooled SF Non-Heated/Cooled SF
•Class of Work: ❑ New ❑Addition ❑Alteration ®Repair ❑Move Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial ❑Residential • If 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: / /
1 t otc e-4 & �rT '�46-,c4 , �`fi' �,,7Yr� �e -
AaE i&
Florida Product Approval# (For multiple products use Product Approval Information Sheet)
Property Owner Information Name .J di((j p/ Phone 8"4o- .31J- ' 5732'
Address ,¢b Ai�.Qno/7 City 4Ue L sae State Zip .3 ja..,33
Email ✓ Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information Name of Company Aly 7 Phone21.0_4 - �-6 cL.,,-6Address ) �.9 La/ n J �rt/J j City b(, � State Zip 3p2�l 1 �
Qualifyin Agent / State Certification/Registration#
Email btu / 6 t/ ,t I -grlu Job Site Contact Number
Worker's Compensation Insurer OR Exempt ❑ Expiration Date
Architect's Name Email Phone
Engineer's Name Email Phone
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 city/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 OWNERL YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT
MUST BE RECORDED AND POSTED ON THE SITE OF THE IMPROVEMENT BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR L NDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF M\ CiEop .
(Signature of Owner or Agent) � :nat : o Contractor) 2
Signed and sworn to(or affirmed) before me this ( day of Signed an. w.LT to(or a fir 'ed)before me this , J day of
Ci/k);-)3 by6 \�� )‘I JOA Y , r by _CALICkTS\ \ \
•
Signature of Notary GJ Signature of Notary
[ I Personally Known OR SA Produced Identification [ ] Personally Known OR [ -roduced Identification
Type of Identification: ,-- Type of Identification: V) JtY`)
` ".!�."'
`Q 'I LADAYIJANICHOLS
��r PV :2+t
GUADALUPE GARCIA ,
Notary Public State of Florida •
�' :*i MY COMMISSION#HH 226065
Commission rt GG 946372 'S. am`.O;
.;r0;;,,a*,' EXPIRES:February 8,2026
My Comm.Expires Jan 12, 2024
NOTICE OF COMMENCEMENT
State of �
lri Tax Folio No. /7 I-13X CtQiO0
County of AJ4?
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: 10-8 16-2S-29E
SALTAIR SEC 1 LOT 496
Address of property being improved: 246 MAGNOLIA ST,ATLANTIC BEACH FL 32233
General description of improvements: NEW DRIVEWAY PAVERS INSTALLATION
Owner: JIM SCHLUETER Address: 246 MAGNOLIA ST.ATLANTIC BEACH FL 32233
Owner's interest in site of the improvement: RESIDENCE
Fee Simple Titleholder(if other than owner):
Name:
Contractor: ITOP BUILDER LLC
Address: 1241 LAKEWOOD DR, SAINT JOHNS, FL 32259
Telephone No.: (904)446-6226 Fax No:
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
Signed: G! � v Date: / . 1-7
Before this I J da� 4rI the Co of.,uval,State
Y y
*;;..,
Of Flo ida,has personally appeared roxw-, - SCT1kAti
GUADALUPE GARCIANotary Public at Large,State of Florida,County of Duval.
Notary Public State of Florida `�-� 1I Commission#GG 946372 ` My commission expires: I ,V +�
oFr�. PersonallyK
My Comm.Expires Jan 12.2024 ( nown: or
REVOCABLE ENCROACHMENT AGREEMENT
f' ;t` City of Atlantic Beach **ALL INFORMATION
j'",1 800 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 Florid , hereinafter referred to as"CITY" and
jetir�j cJ 4.A/fit, Gr 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 Front Entrance Driveway
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 246 MAGNOLIA STREET,ATLANTIC BEACH, FL 32233
• 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.
/0.V /� Date / /,Y 2-.i
Property'Owner/Agent(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this 9‘-- day of ,20 1
by V��`, , �C_�1As... ,/ (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
[ I Personally Known ' t
[ 41Produced Identification(Type) Public Works Director Date
ip 4:, GUADALUPE GARCIA
`V Notary Public-State of Florida
\7?oFf�':- Commission#GG 946372
'..,OF M1;
My Comm.Expires Jan 12.2024
MAP SHOWING SURVEY OF 1
LOT 498, SALTAIR N0.1 AS RECORDED IN PLAT BOOK 10, PAGE 8, OF 1
THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA,
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NOTES: /
1, TNIS 15 A BOUNDARY SURVEY. BUILDING.
2. NO BUILDING RESTRICTION LINES AS PER PLAT.
3. NORTH PROTRACTED FROM PLAT..
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