1611 Ocean Blvd RESO24-0033 PermitOWNER:ADDRESS:CITY:STATE:ZIP:
MORGAN GROVE
PROPERTIES LLC 1659 HERTFORD RD CHARLOTTE NC 28207
COMPANY:ADDRESS:CITY:STATE:ZIP:
2 MEN CONCRETE INC.1001 OLD SAINT AUGUSTINE RD 2110 JACKSONVILLE FL 32257
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169555 0000 OCEAN GROVE UNIT 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1611 OCEAN BLVD
RESIDENTIAL OTHER SINGLE OR
TWO FAMILY RESIDENTIAL
OTHER
REPLACE CONCRETE
SIDEWALK WITH PAVERS $4511.00
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.
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 2Issued Date: 3/29/2024
PERMIT NUMBER
RESO24-0033
ISSUED: 3/29/2024
EXPIRES: 9/25/2024
RESIDENTIAL OTHER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00
TOTAL: $129.00
2 PUBLIC UTILITIES ADDITIONAL COMMENTS PUBLIC UTILITIES INFORMATIONAL
Notes:
See Revocable Encroachment Agreement regarding driveways/pavers and public utilities in the ROW
3 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.
4 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.
5 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration, including sod, is required.
6 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.
7 PUBLIC WORKS GRASS INFORMATIONAL
Notes:
Full site to be grassed.
8 PUBLIC WORKS REVISION INFORMATIONAL
Notes:
Any plan change must be submitted as a Revision to the Building Department.
9 PUBLIC WORKS DEBRIS REMOVED INFORMATIONAL
Notes:
All construction debris must be removed from job site by Contractor.
10 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
2 of 2Issued Date: 3/29/2024
PERMIT NUMBER
RESO24-0033
ISSUED: 3/29/2024
EXPIRES: 9/25/2024
RESIDENTIAL OTHER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
o-ev,BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
s' City of Atlantic Beach Building Department PERMIT# ESoZ4- 003
sl
800 Seminole Road, Atlantic Beach, FL 32233 ALL information required to process
Ji3J9Phone: (904) 247-5826 Email: Building-Dept@coab.us
O
Job Address 4 6 I I OCEin1 Pq,Vp , Q-i-i Rir c g1=AuId , FC 32.2,3 3 RE# I Co +SS-Opo0
Legal Description 001-)0.,(k C r-ov P_ U ext4 i , - f 7j L 1 s 1 S,12 I g( k
V Valuation of Work(Replacement Cost) y S 11 • I Heated/Cooled SF Non-Heated/Cooled SF
Class of Work: Fi New EI Addition Alteration 1=1 Repair Move Demo El Pool Window/Door
Use of existing/proposed structure(s): Commercial 11Residential • 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) 7 No
Describe in detail the type of work to be performed:
Re-PC ACF SI.eWaiK w4y . Fv,,on, coNCe 7 7Z2 PA EES .
Florida Product Approval#For multiple products use Product Approval Information Sheet)
Property Information Name I s,v,q ,gr Phone 4 ?oq- ?c 3 -.3/65,
IAddress s9 He r't"tbl R. City 0_,hra_10-1--ito Ikk
State Zip Z•S zo7
Email Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information Name of Company 2. me-Ai co,cz 6 7E- /A). Phone 1 c94 - 4-10</• 6.8gei
Address 11 00 1 OLD Sr 4U6u5r/ dE Q1) City v40/5D/JV,i g State 14.L Zip 3225--}
Qualifying Agent State Certification/Registration# 4 0 3 006
Email Z MEN cG ,eC :Al (j/?A/t, G,piti Job Site Contact Number
Worker's Compensation Insurer OR Exempt El 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 BE RECORDED AND POSTED ON THE SITE OF THE IMPR•VEMENT BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSUL Ab _
ORNEY
B r
EFOR RE RDING YOUR NOTICE OF !,OM F __.:'MENaNIGINDLESPERGER
11vi s.= .MY COMMISSION#HH 4071227z.. I Fa,....•• EXPIRES:October 6,2027
Signature of Owner or Agent) j 97:.1-1.. Signature o on rac or
Signed and sworn to(or affirmed) before me this f p day of Signed and sworn to(or affir Fel) bef• • me this ( D day of
AtWC,\(\_ , 2o2`1 rtSf1.,'•; ,rrtifro•( C ZOZA by ( !.jkD
Signature of Notary -Tu t4A.A I h(C C.' , `
f --» '' .:
Signature of Notary TIM
NOTARY
Personally Known OR [04-rroduceid Idjentific*on 1 I [ ] Personally Known OR [ ] ProducedlIdeal ation^
i
Type of Identification: A/C-171.— 1,. . PUBLIC
r
Type of Identification: D L . V1A.q_r (Q/\( 1.
4' ''•. TONI GINDLESPERGER
4S? '•° MY COIAMLCRInu r Liu An74,1„ 11
s•A,i-, REVOCABLE ENCROACHMENT AGREEMENT
t Via\City of Atlantic Beach ALL INFORMATION
800 Seminole Road,Atlantic Beach,FL 32233
HIGHLIGHTED IN GRAY
IS REQUIRED.
J
REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida,a municipal corporation organized and
existing ung
er the law .,of the S of Florida, hereina er referred to as "CITY" and
o IVy) (a70at ` 1ror ilaj of Atlantic Beach, Florida, hereinafter
referred to as" SER".
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 17aikey /i,u 2414,v ti Se"
Any facility maintained, repaired, erected, and/or installed in the exercise of he privilege granted remains subject to
relocation or removal on thirty(30)days'notice by ITY to SER,said rM to SE II be ivep b icertifem ,return
receipt requested,to the following address i( e//Cal VI I 1..) ` ,moi
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
reb ssumed by the USE ./
C— 72/L../ Date 6 `d /
Property Ow/er/Agent si ned in presence of Notary Public)
L 13
STATE OF FEORIDA,COUNTY OF DUVAL 7-I-\
The foregoing instrument was acknowledged this ! day of / " Ulf C 20 2 1
by C In rj rS h k cA Co \1t, e 1/ printed name of Signer),who personally appeared
before me and acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
P 0 4v:- kh(c vDepartment Approval:
S'_nNtORAdtf)N4tarjt Public, $tate°LEW--ida /1/0?--1-1._, c_zkv-o I i'vl-Ck
I] Pers*Hy Knbwn
Aktirte ndentegation(Type)/UL/?L-. Public Works Department Date
i
R4v glitrg C pe2023
MAP SHOWING BOUNDARY SURVEY OF
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PAGE 82, Of THE WNW.N I PU81.IG RE CORDS Of f)U VAI. (:UUN I T, F 1 ORIDA.
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TOC RQIHERT C,ALDYILLL, III & CHRISTINA MAR1I YN t:ALO'A LL
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