355 11th St RFNC24-0036 - fi.,. Building Permit Application Updated 10/9/18
r• L j`
r , -, City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
`<Z'°liw'r IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: 3S5 J14L moPermit Number: R F"I\ C. ZA-- v 0 3
62
Legal Description S—C9 I C, -2 5"29 E , 172. RE# !70108_00)0
Valuation of Work(Replacement Cost) $ 2900 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: New ❑Addition ❑Alteration 1/Repair/❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ECommercial PJResidentia'l
• If an existing structure, is a fire sprinkler system installed?: EYes �No
• Will tree(s)be removed in association with proposed project? EYes(must submit separate Tree 121N
Removal Permit) o
Describe in detail the type of work to be performed: Ref 3 5/ o / C /t/ l,Jo f/r�tu- ,N Sgiwr_,
I ocr-s4 rovl .
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name 'rlotc,1 . Address 355 11.,..1.,11.,..1.,City AfIur}b;c, I,7ccJState F1 Zip 322-33 Phone 9O4 tin kV3Z
E-Mail AA:trc.Kt - .t- CH06 'MO. cwr
Owner or Agent (If Agent, Power of Attorney or Agency Letter Required)
Contractor Information ,
Name of Company SA I w rutii.- 111? I Qualifying Agent Bve / J�,p
V if-e,✓
Address S97a /4 A
; l,voy wry City ju �•
s �)1c, State F / Zip 31Z51-1
Office Phone 101-1— 683 63 y er Job Site Contact Number
State Certification/Registration# (`S S'S1 E-Mail O cc c�J, -- c,j Ut+5 ,/1/Jz . c.Y4
Architect Name& Phone# vac�vt
Engineer's Name& Phone# � � ���
Workers Compensation Insurer ccvl cry OR Exempt❑ Expiration Date I v/o Z/ y
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 OBTAI f ACING, CONSULT WITH YOUR LENDER OR A A OR BE ORE
RECOR NO ICE OF COMMENCEMENT.
.moi
ignature of Owner or Agent) /eignature of Contractor)
k
Signed and sworn to(or affirmed) before me this I `7 day of Signed and sworn to (or affirmed) before me this `r day of
,err _,2a.: _Ik_ - ]kis 2 - Rex(( h , 10Uci , by (' ; 1e (3(cbJt(�a pike)/
=e. TERRY HENDRY V l
Croduced
' • votar ?;blit•State of=lorida i (5ignature of Notary)
• Commission,HH 1E544
My Comm.Expires Nov 30,2025
CHRISTINAMASSARA
Notary Public-State of Florida
a/TV 17nCi Mn'0I� L [ 3 Personally Known OR '� "=' c' Commission#HH 45174
Identification oduced Identification �F °C�r � My Comm.Expires Sep 22,2027
Type of Identification: ` L Type of Identification: r �� l_�_
';''' -� Fence Addendum Updated03/07/2024 jCity of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233 PERMIT #
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date:
355 I 14-L S-t- 03 As/ 29
Property Type: Ig Lot/ Type/ Features:
Q"Residential One Street frontage (interior lot)
❑ Commercial ❑ More than one street frontage (corner lot, through lot,
etc.)
❑ Swimming Pool
Fence Material: Fence Height (select all that apply):
"Wood ❑ Four Foot (4ft)
❑ Chain Link ®'Six Foot (6ft)
❑ Vinyl ❑ Other
❑ Block/Stone (Plan details required for footings and/or
retaining walls)
❑ Other
Fence Location:
Please submit an accurate and current boundary survey showing all existing improvements (including building footprint,
driveway, swimming pool, etc.) and location of fence/wall and any gates. Plan details required for block wall footings and/or
retaining walls and any portion or fencing above 6ft in height.
Will the fence be built in an easement?
❑ Yes (must submit separate Revocable Encroachment Agreement)
E/No
Will tree(s) be removed in association with proposed project?
❑ Yes (must submit separate Tree Removal Permit)
/No
Conditions of Approval:
• All old fencing and debris must be removed from job site by contractor or homeowner.
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.
MAP SHOWING SURVEY OF
LOT 28, BLOCK 14, PLAT No. 1 SUBDIVISION "A" ATLANTIC BEACH AS RECORDED IN PLAT
BOOK 5. PAGE 69 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
LOT 25
LOT 27
FIELD ) r0urb t/1" _.
LOT 29 1 OS
4 .86' 00� o.' vroc NO 0w —
LOT 31 ) 0 e' 5• COO'
i,NN R"�� -
(•9.95'ntL9, p YAGNA1l72 O 6 e--,Z00-1:6.4a rt ,5151 °
50.00 — •U� .90'10'12" oA' 6g o r
Folio •IO Oa 0 r 6'w000 rt .
VII'
PIM CAP — --
a
\el I
1 ;5
6g ,Im .,
1 I 1 4
\
!� ? '��'o ILO
c
Gl SCALE: 1" - 20'
B 1- covso,tt�voaa 7.5'
11 35.2'
o' aIP t �u LOT 26
I • 2a o
LOT 28 8 0
•a Q r
LOT 30 0(7tr,
0 2 STORY CEDAR 1 C o
LOT 32 0S
I 8SHINGLE
RESINo.DENCE355 a R
I Q D
. FENCE Ln
O OK
I n
I O
16.0' 1 q
\ n - If.
n� p�t
C7
70
1 OfitivE 01°,x U S
1 -VA *
(N
-----\-
85000
89j�.
r
90^ti0F0 maE Mp/tM
( 5 /r+o IV 49.0 FIELD)
Fan
rpMO��w ',.
BENCH MARK: MAGNAII IN EDGE
OF PAVEMENT 47 N.OV.D. 1929
81ELEVArONa9
NOTES STREET
1. THIS IS A BOUNDARY SURVEY. lith_}rL'
3.2. NORTHI PROTRACTEDNANGLES
AS
FROM FIELD
PLASURVEY. I 1 `•' WAY PAVED PUBLIC ROAD
4. NO BUILDING RESTRICTION UNES PER PLAT. 40• RIGHT OF
5. BENCH MARK USED IS A NAIL IN A WOOD
POWER POLE NEAR THE SOUTHWEST CORNER
OF LOT 30. ELEVATION = 11.08 N.G.V.D. 1929
6. BUILDING TIES SHOWN ARE TO THE
FOUNDATION.
THE PROPERTY SHOWN HEREON APPEARS
TO LIE IN FLOOD ZONE "X" (AREA OUTSIDE
THE 0.2% ANNUAL CHANCE FLOODPLAIN) THIS SURVEY WAS MADE FOR THE BENEFIT OF
AS WELL AS CAN BE DETERMINED FROM MICHAEL KOSTER and ROBIN KOSTER;
THE FLOOD INSURANCE RATE MAP No. COMMUNITY TITLE LLC; AND FIDELITY NATIONAL
12031C0409H, REVISED JUNE 3, 2013 FOR TITLE INSURAN COMPANY.
DUVAL COUNTY, FLORIDA.
"NOT VALID WITHOUT THE SIGNATURE AND DONN W. BOATWRIGHT, P.S.M.
THE ORIGINAL RAISED SEAL OF A FLORIDA BOUNDARY SURVEY RECHECK FLORIDA UC. SURVEYOR and MAPPER No. LS 3295
LICENSED SURVEYOR AND MAPPER." - AUGUST 1, 2018 FLORIDA LIC. SURVEYING &MAPPING BUSINESS No. LB 3672
CHECKED BY: BOATWRIGHT LAND SURVEYORS, INC. DATE:
DRAWN BY: SwC JULY 13, 2017
FILE: 2018-1257 1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 241-8550 SHEET 1 OF 1
2012-051a 12-0973 13-0212:13-1011:17.-N116