1723 E PARK TER RESO24-0024 s?jJ'J .� BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
• 0 •City of Atlantic Beach Building Department PERMIT# �C - Z`� (�JZ�F"
a%i'/ 800 Seminole Road, Atlantic Beach, FL 32233 **ALL information required to process
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address [1 al PuciL 'Ttcrti e, RE# '1 (2Dat) --O o0
Legal Description 19 - qS - 061 -).6'
—al
Valuation of Work(Replacement Cost) I 0 IC 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 DResidential • 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 ( ► Idetail the type of work tobe p
�e
`rformed: ,(//
In 511,-R 1 pI41 AT 11 (RLIG( 101 OA 6'0 ijej.s of rc.,j,'dc,
S OO s'1
Florida Product Approval# (For multiple products use Product Approval Information Sheet)
Property Owner Information Name Phone 1 O�-7 . (�1 Q
Address li/a,3 puy-j I#-r 1✓'. City/ �.14,clfiG �(,GL State 7 Zip ;a33
Email Du{.(C Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) r1
Contractor Information Name of Company (Of ! Uy f (..i)(n 1p Phone 1 0(1. is-t.La-U'13
Address al b ! 1 J jL4 /
L City �Q B I State FL. Zip laa�3
Qualifying Agent 1L,u� U StateC+ertification/Registration#
Email a6 0Dirt d4 ui F (b/yip df6,1 „LOA' 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 OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT
MUST BEREC$RDED AN , POSTED ON THE SITE OF THE IMPROVEMENT BEFORE THE FIRST
)JSrPECTlON. IF YOU,6! D TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
TTo ' .:47:EFORE RECORDING YOUR TIC OF COMMENCEMENT.
._..gim,A,"
is .ture of Owner or Agent) // 44 (Signature of Contractor)
Signed and swor • (or affirmed)before me this LO day of Signed and sworn to(or affirmed)before me this Leh day of
MG{0A , .2 by VY ,\ MC�YC�(1< , Z724 by O tY. ":1- 1(1Y)W)
\-&;-,,Signature of Notary `-� Signature of Notary jt\r r\/-
[ ]Personally Known OR roduced Identification [ ] Personally Known OR oduced Identification
2J
Type of Identification: ��\>�v5 ��- Type of Identification•. �-�Y� _,�C�'�
7♦ I _M 1 ♦ I
t 4`1"1:., LADAYUANICHOLS f+� ^'; LADAYUA NICHOLS
*•• '�; '+: MY COMMISSION 8 HH 226065 loi ,; MY COMMISSION#f H 228065
"a:.�`ic? EXPIRES:February 8,2026 ='�s poi EXPIRES:February 8,2028
c+? fiQr
o,, MAP SHOWING AS-BUILT SURVEY OF
CURVE DATA Cl GI LOT 2 BLOCK 14 AS SHOWN ON MAP OF
N04'48'19'W I
-7) 4-).
CH = 99.41' I �"? I $ SELVA MARINA UNIT No. 8
R 4744.65' 1 ; L 0 3 8�$ 6'MOOD 61 L 0 T 2 0 AS RECORDED IN PLAT BOOK 34 PAGE BS OF
A 99.41' I� BLS K 14 I FENCE
till;� BLOCK 14 THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY FLA.
D = 172'02' 138.73' (A)
1138.41
((BEARING BASE) I138.4'7r (P) (11.3) 01 CERTIFIED TO: DEREK JOHNSON
N868'07'E REGIONS BANK DBA REGIONS MORTGAGE
� J;la9), D' (51'8)) DOMINION TITLE CORPORATION
(10.3)-1-- 1) 6)� .,I °°- l(/0.9) �- -p2O.Br- CHICAGO TITLE INSURANCE COMPANY
(10.3) l- 4'4,;.:)<-,: c.,
` _-PI--- 7.S•BR.4__ EA ((1I.0 I
,Y ) 22.3' (10.7) L 0 T 2
--- -----
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BLOCK 14
32.0' i%'I 19.4' 561
(8.8)\(p, Y.I 28.Y ]6.3. i ill
..I _1..: ilL):),
A
(9.9) - (8.9 %I m
f a (10.2) .,I N I 16.0' III' I EOilo
JO 14.3' BENCHMARK:
1 LI I''11t1'1'''11r i iq m LLBBD385 L 64 DISK
N (8.7)1 >�I 26.9' J ( 41 NI
(9.0)1
e D) 320 �-{ 260'± S. OF THE RETURN ON 1
W $ (e 9) 1 (ARC)( rt�1'1��ii.1.i■ � (^I� ;72, 1 1 I 1 I I " PARK TERRACE EAST & 17TH
e'' i X11111 I 1 IIIII (�''IUU•=)N Z m IIII �I1IIII I I R L BLGCK 14' sT., wesT EDGE OF ASPHALT.
L ELEVATION:(7.66)
13 (101) _� 111 IIIII � � ,a°p o IIII '1111 I •
• ••IIIII li 19 IIIII taq 7.5' ,...,:i, R II'I'I'1'111'I''I 9D ELEVATIONS SHOWN HEREON
D 9 49.0)
REFER TO NAVD OF 1988
`I�4*<< IIIII 1.1g1�1�1�1,III N N
(10.,, 9III $;,% I I I I 11 I 5.1Id ($D 4)
.111 e"I111111111 I _ (10.2) (B.(1o.o)
pi�1I11111I1I111I1I111/ 1 I 670
(6.6,, o 0-DENOTESDFND 1/2 I.P.
I l l l l l l l lr IcoNcRETE
NO I.D.
11 I I 111114 (m.4) 3,3'%3.3 I 2.Y `(&e) II UNLESS OTHERWISE NOTED
i111111111°Ii I I1II I v-DENOTES STREET SIGN
1 l 0.6)) x( -(8.7
-DENOTES CONCRETE
-. 90 15.9' v (0.7)
s N 11'1''(' ', (10.2) )\ 1I ( ''I 22.9' e/ qR�y O m I o ®-DENOTES WOOD DECKING
(0.9) -(B.2) APPR012YATE TOB ��j�,yJ 4) \m'1SE$ (10.8 BO(-DENOTE BACK OF CURB
I x -X.�i (10.6 EDP-DENOTE EDGE OF PAVEMENT
x(0.6) t a v I x(9.7)/(9.9) (9.8), (1 11.) �o^, r ' YA'O.B 3-.S (00.00) -DENOTE TOPOGRAPHIC SPOT ELEVATION (HARD SHOT)
rn 1 O h)
(10.8) (10.7 (10 6) ' •' 137.66'(p)C� DRAIN (00.0) -DENOTES TOPOGRAPHIC SPOT ELEVATION (GROUND SHOT)
�.p•� 518NTN SFd� i • L 0 T 2 3 - DENOTES 4"SANITARY SEWER CLEAN OUT
J'6. (64.1 I. TO FENCE)II B3,445.16.W I \ BLOCK 14
1, ri
Pi
-47q
I �'
�;/� p _- N I T FINAL FEE.;SHOW,TIES
4954;11-1 20211 (10.0)4964: 12-13-2021 MELD)
VA �n _ ( L G T 1 FOUNDATION.F.F.E.,W.0./106445:02-23-2021 (FIELD)
4 4 9 I BLOCK 14 THIS SURVEY WAS PERFORMED WOHOUT THE BENEFIT OF A TITLE COuwTNENT.
'[b I
(^- THERE MAY BE AOgfgNAL EASEMENTS AND/OR RESTRICTIONS TINT ARE NOT SHOWN
ON THIS SURVEY THAT MAY BE FOUND W THE PUBLIC RECORDS OF TILS COUNTY.
% I( VA MARINA UNIT No. 6 1 UNDERGROUND ENCROACHMENTS NOT LOCATED
r. THE LAND SHOWN HEREON IS IN THE SPECIAL FL300 HAZARD ZONE'X"AS SNOWN
'E I Bpa( 34, PAGES 51-5T8 -' ON FLOOD INSURANCE RALE IMP 0407 J FOR DUVAL COUNTY.FLORIDA.F.I.R.u INDEX DATE I1-02-18
ALL AMERICAN SURVEYORS OF FLORIDA, INC.
�1
DN...we.HEREON Ala PEN H.NL rI.NKY LAND SLREYDWS-3205 SAN.ARSE RACE 5195E 05-,NOIsowHZE HONDA 32ffi7-904/279-0068-MIMED IAF)LIMINESS MO.3837
LOT 2,BLK 11 CUSTOM,LT THIS IS TO CERTIFY THAT THE MOVE LANDS WERE.SURVEYED I 4I
=../ UNDER MY RESPONSIBLE SUPERVISION AND R�11 �TITM1AS; -
P'4Oi LOT SIZE 13,2672 50.FT. �ir2 )� Pt. THERE ARE NO ENCROACHMENTS ETS 3)1 9yl�YfTAt Al.l.
ato..! DRIVEWAY To R/W 1.1782 S0.FT. THE SURVEY SHOWN HEREON MEETS SL16Fpv1.01LY,J
II!�-� .1; STANDARDS SET FORTH BY T 'YL AP DbF
PGG c1P� LEAD WANK 02 50.FT. .As PROFESSIONAL SURVEYORS AND.AP PURSUANT T 5. AMERICAN
��y CHAPTER 472.027/CHAPTER■IG,Y.- FLORIDA STAjOC
APPROK■IAIE SIDEWALK O4 50.FT. :g.� Fra 4 SS• - SURVEYORS
•A - RIGHT-OF-WAY LENGTH 99.41 R. nj u
SURVEY NOT VI11D U1(1j33 O BY;5OF FLORIDA.
TOTAL IMPERVIOUS AREA 5,8672 SO.FT. 438 T ...w =.1.0114.4=11
'�9.D.Fl�T RD, 2 INC.
coma um +,4 w4 N wAm ""SCALE , �. H■LtiY¢L OIAfdFf WDA 9643. 0 zi
SIDE/FRONT TIES ARE TO THE FOUNDATION.L m Rm.. M r= MAI MS ''' _9
,04 r °ATE 03-02-2020
. • •NRI" _B
F.B. SKETCH D.C. 07627-194964 DR. BY TH D,+, P:\2020(673R2)\CHESAPEAKE CUSTOM\S VA MARINA ORDER Na 194964-FNL "LE 87627