2027 VELA NORTE CI DWAY24-0011 -- Building Permit Application Updated 10/9/18
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�, " r City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
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Phone: (904) 247-5826 Email: Building-Dept(E�coab,us IS REQUIRED.
Job Address: �- e l ii r j- 7_,ir'L(.e Permit Number: F L) (Z4-Do I (
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Legal Description 31,..q 6/ Oq-75- ZcL: 571iitliae,e L" /-2 4,4 SZ RE# I" `?S06 -P+ 0 '1
Valuation of Work(Replacement Cost)$ lit 6 Ob Heated/Cooled SF Non-Heated/Cooled
• Class of Work: DNew ❑Addition '1 Atteration ❑Repair :Wove ODemo DPool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial ,Resldentlal
• 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) o
Describe in detail the type of work to be performed:
/Re prztte__ (cocrtly, w014-Ltdi4 1 ) i , 1 ea_ F i
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Florida Product Approval# fbr multiple products use product approval form
Property Owner Information `�
Name I'�Gr-!F,C k Address x e 1 V[if4,Iht C1!&
City r State r L Zip 3 t-t ) Phone
E-Mail s/C Werke/(0 ('-r►,,-, 1•tom,-,-ti
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information /) .( ,, i 1 core. I
Name of Company P e J ( .{ter/C. Qualifying Agent
Address (Fl 4{po-r' Re tet City ia^j'IQ.e'hit.-8('rr>r,1n State Ft Zip sZZ-33
Office Phone ! lob Site Contact Number
State Certification/Registration# E-Mail in'tp nC 'i.-Wi n L „ Lor'"
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer Afn'r?54- _. _ OR Exempt 0 Expiration Date 9/3 D/2.r
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
RECORD NG YOUR NOTICE OF COMMENCEMENT. .- /'"/� _
1-eA/fc.4 / i ce
(Si ture of Owner or Agent) (Signature of Contractor)
Mand sworn to(o aff me )before •this, day of 'g ed nd to or ff -d)before - this 4,... -y of
t) zczd ,b -{. f.-- ..• ', 1 t--1
740011
.. . s._ —_ter • at. d________
z?.•'' 'fir• TONI GINDLESPERGER
Trii '7' Two SAI +' 407122 ( )Personally Known OK' --
'• •• pS 441 2427 Produced Identificat• 't.••oP , )PrC �LnA€rCxnF>6, r [ ] • . T"ri iIN7LESPERGER
i,,, Ili A L,�A, __d 4,�: , Type of Identification: .: * ._ ►,?v ClIAKIISSION a HH 407127
•-•:;::"(..*.'P*°' i::XPIRES:October 6,2027
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�s=+ RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION **ALL INFORMATION
)n 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
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Job Address yeti 1 aAG `'(� 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 AmTrust OR Exempt®Expiration 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 shall be notified 24 hours prior to starting work and again immediately upon completion.
10Laki.. Date (1.2
Permittee(signed in pres nce of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL 1
The foregoing instrument was acknowledged this l day of �iT ,20 2/e '
by p.el ��N ��e i CL w_,. ,who personally appeared before me and
(printed name of Permittee)
N''''.
ackno I-:ged th t he/ h signed the instrument voluntarily for the purpose expressed in it. ° =. TONI GINDLESPERGER
MY COMMISSION#HH 407.
EXPIRES:October 6,2027
[ )Personally Known
Signature of Notary Public,State Florida [ J Produced Identification(Type) _ _______,_
H:\Applications&Forms\Word Documents\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18
REVOCABLE ENCROACHMENT AGREEMENT
City of Atlantic Beach "`ALL INFORMATION
i HIGHLIGHTED IN GRAY
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 of the State of Florida,hereinafter referred to as"CITY"and
kL " •f e-1 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 asa-1\ft "
l/
Any facility maintained, repaired, erected, and/or installed in the e ercise 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 Z 7 Ue).
• 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.
1. l Date 2/l it I a " `l
Property Owner/Agent(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this l day of , 20 Z` t ,
by Kee_ILI. ,1 (printed name of Signer),who personally appeared
before me and ackndwledged that he/she signed the i strument voluntarily for the purpose expressed in it.
Department Approval:
Signature of Notary Public,State of ori.
[ I Personally Known
[ ]Produced Identification(Type) Public Works Department Date
Revision Date:05/09/2023 ro`'p:' -. TONI GINDLESPERGER
N: i tl' MY COMMISSION#HH 407122
--;;;"W;&",-: EXPIRES:October 6.2027
"fOF FlO,,
j-IP�� TREE & VEGETATION AFFIDAVIT FORINTERNALOFFICEUSEONLY
f City of Atlantic Beach PERMIT#
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o Community Development Department
01j-IP-41\
800 Seminole Road Atlantic Beach,FL 32233
‘t- —}r (P)904-247-5800
SITE INFORMATION ` /p iis
,�f I/ADDRESS �i V L / 1(f! �[<i :'Y/ /
n 1 /
SUBDIVISION ` ' /,4 �€ L/()," BLOCK LOT 5 L
RE# / cc - // V ❑ RESIDENTIAL ❑ COMMERCIAL ❑ OTHER
APPLICANT INFORMATION ,�
NAME kire_d-C/ 1 PHONE#
ADDRESS Zell V e4 f 1��� (/,'c CELL# 6/1(3 Z 5y 33-s Z
CITY A-6 STATE FZ ZIP CODE 3 Z 33
EMAIL 5/e/Fk de/ (r_ C-of /. C2tf jliOWNER ❑ LEGAL AUTHORIZED AGENT
I affirm that I have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation", of
the Municipal Code of Ordinances for the City of Atlantic Beach Florida and/or I have participated in a pre-
application meeting with the Administrator of those 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.
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT:Signature of Property Owner(s)or Authorized Agent
SIGNATURE OF APPLICANT r� � I /
PRINT OR TYPE NAME DATE
SIGNATURE OF APPLICANT(2) PRINT OR TYPE NAME DATE
Signed and sworn before me on this I day of t- 'e b oZ4 by State of r r 1
/11 County of Lv VOL
Identification verified:
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.)kr4C--- .
Oath Sworn: ❑ Yes i No
S :Y:; • Notary Signature
:',?:Y:; "--, TONI GINDLESPERGER •
y„n MY COMMISSION#HH 407122 My Commission expires
FGF 0,•' EXPIRES:October 6,2027
04 TREE AND VEGETATIONA • .' . .1 . I
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< <',yr
-ikf J�`tA CITY OF ATLANTIC BEACH
, 800 SEMINOLE ROAD
r' r
-} - ATLANTIC BEACH, FL 32233
(904) 247-5800
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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. l
JOB ADDRESS. ZL)t7 \/e ?a (tI iG�
OWNER or CONTRACTOR (Print) 1-lam ie 4
Signature 4-1 Date 21 l le /2 0.2 y
1
iiiLANDMARK 21052953
T T L E BOUNDARY SURVEY
.::,
DUVAL COUNTY
904 - 998 - 9733
a -r `•
E_ LOT E1114.98'(!I) P� `v `�
., R ,.l<'.' N 76.22°.E 174.63'C `�
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16a31'41 ` \ \\ m
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'bG. '- „ / '\ \O INOfIP T \� \tt
PROPERTY ADDRESS: Z'\. ..13.
10 n I/dC \ \ \
2027 VELA NORTE CIRCLE,ATLANTIC BEACH,FLORIDA 32233 \/ \\ \;m rn m
SURVEY NUMBER:FL2105.2953 \ ) 1 LOT 52 1 STY 41 T 1tg"; 0>
1 ,A7ro o 402 nc RES 82027 E eR �, t 1 SDATE OF SURVEY:05/24/21 I FIELD WORK DATE:5/21/2021 7.9' 6 3 1^ 91'IP I 147' `r '4173 3 m
REVISION DATES): ".°.T. -1 - x.4'. 74 N 21 m
0o RI L q
(REVD 524!2021) C - -'n- z.4 ` Q d
POINTS OF INTERESTI rn r5 r- 411111111111'QI
1.CONCRETE DRIVEWAY OVER 10'JACKSONVILLE ELECTRICAL AUTHORITY Cl- 2 Y_, ` M I ,1
ELECTRIC EASEMENT 2.DITCH OVER 25'DRAINAGE EASEMENT 3. R= 1375.001P/1M) - - 1' _ I
DITCH OVER 10'DRAINAGE EASEMENT L. 26.971P)26.98)M) - 1 1
A= 1ror29(P)roTZB(M) '' ---• ` I I PPe
N 3°1525"W,26.97'(P) -...j J J
N 3°5746"W,26.98'(M)
5.1' / n
C.) _- .a D.E. i ` LOT 58
SURVEYORS CERTIFICATE C-2 x1
R. 185.00'IP8k1) rte- °ue % 12•MR
-—-
. NO p
��;O g 1'8C_H,je I hereby certify that this Survey of the �_29'49Ipg•27.87(M)
p�g 39 )M) r .r2•re. S 87°5532"W 181.46'(P)
'0 lands described hereon was made p NO ID SBI'S592'W 181,40'(M)
4w� �°q N 8.39'47-W,27.86'(P)
under m direct supervision,and to I B.R.(PER PLAT)
6132 Yknowledge
N 10°53'35'W .87(M(M)
the best of my knowledge and belief �} LOT 53
is a true and accurate representation I
`�" _ of said lands and meets the Standards
N r of Practice set forth in Chapter 5J-
)054'
15.050 through 5J-15.053,Florida
Administrative Code,pursuant to
�S STORE A section 472.027,Florida Statutes.
��%..1:PIARR)A. This survey is not valid without the
�s URV!'( signature and original raised seal of a
RAYMOND J.SCHAEFER Florida licensed surveyor and mapper, UNE TABLE.
Stem of Yonae araiessnnel Surveyor da Mapper except when the electronic signature LI S 15°5915"W 17.00'(P)
License Number 8132 and seal of a Florida licensed surveyor S 10.5445°W 17.09'(M) _
Em.Lad sw.von,LLC I Le84281 and mapper is affixed hereto. L2 N 31015'W 159.63(P)
N 5°5942"W 25.07'(M)
A (-- c---
•EXACTA w<u landS°rv.ya.LLC SURVEYOR'S NOTE: ) s it j N
. Land Surveyors,LLC 1aaa291 EASEMENTS,IF SHOWN.ARE BY PLAT OR DEED.UNLESS OTHERWISE NOTED. r-� ® b Ls C
9 0:866.735.1916 1:866.744.2882ille,F32210 J.E.A.-E.-JACKSONVILLE ELECTRICAL AUTHORITY EASEMENT \ ��[\ \ ` . 5 30
4 mm i0 1�
3846 Blandin Boulevard,Jacksonville,FL 32210 '. ��c �_ �• L r
Landmark Title `^y\ ft�pp J N GRAPHIC SCALE(In Feet)
sa `) 1 � O S = V�-1 1 inch=30'h.
—% �.J
. _ SEE PAGE 2 OF 2 FOR LEGAL DESCRIPTION � v.,
PAGE 1 OF 2-NOT VALID WITHOUT ALL PAGES