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318 ROYAL PAMS RFNC23-0054 BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY (,:-*, City of Atlantic Beach Building Department ,. , PERMIT if RrtvCZ4 - 005 ' 800 Seminole Road Atlantic Beach, FL 32233 ' A-ALL information required to process "' r= Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address .3 ('s' `�Z©'/14 L, I?4(L)V RE# /7/701,o-c20) Legal Description 3( I lo 33'-a5 44 MOP-1'70F /41,P4GN?C, (JA/fra A LOT // /34./8 Z C Valuation of Work(Replacement Cost) 2330 Heated/Cooled SF Non-Heated/Cooled SF •Class of Work: ❑ New El 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: 7-6 011)1)6 UL'D frJCIU D JCC `t--c:P cA&C G,j ,-r-IA IN Ai i vT Y t t" % t- Frci/CC 6 'oj,'i>y ' Florida Product Approval# (For multiple products use Product Approval Information Sheet) Property Owner Information Name e. ,., 6-/2,e e1,5L 7/ Phone &-W4/7/ 7sZ J' Address 3i '9�.4 pigZ/44 5 City 47-LA....--ic / 11 State E(� Zip 3223 3 Email Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company t� i1C5 fF''CG Pe-64d-(b7-6/02..4 Phone 9e/3./ 7) T75�_ Address NS/ J ATC.STIC,CA( .5 p, City JACk5OJ1//L A.. State U Zip 3203 Qualifying Agent J 04 pvr (), -f State Certification/Registration# Email " E-,0.1650e6) ,a/G . (1,,,,-, Job Site Contact Number q 145" 7 )' Worker's Compensation Insurer n 1 `'7 3.5*-r- OR Exempt ❑ Expiration Date /j2 Z'-jr— 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 IMPROVEMENT BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. (Signature of Owner or nt) S..e,,evt seitaweer (Signature of Contractor) Signed and sworn to(or affirmed)before me this /,2 day of Signed and sworn to flora` firmed) before me this fc day of 1110. 01 , „ t by st'ca A- lii•)1 N4 4/140Q.c , D-0by -Se.-Sf- c.0.4-I i l?./ie Signature of Notary „(./4.01.4,c.,. Signature of Notary 3-Vf-)tri X" [ ] Personally K wn OR [gl Produced dentification [Personally Kn n OR [ ] Produced Identification A.% Type of Identification: t P. , . . . _ _ Type of Identification: .):-,Y. ',. Jessica A Doiquist y PubNC Stele of Fbr108 M:Comm ssion HH 142217 Jessica A Doiquist '*•7?n, Expires 08/14/2025 a Expires 08/14/2025 142217 Fence Addendum Updated 03/07/2024 J �\ j City 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: 31s, 26,74L pa-L nvl y /d/z Property Type: Lot Type/ Features: 12:1 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) fe'No Will tree(s) be removed in association with proposed project? ❑ Yes (must submit separate Tree Removal Permit) "‘o 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. PREPARED BY: l��ti ( qtr r_ {, p } N.C. P 3,......„,1 �k=r, - ``'y�1Jrr't�,, 0.10 y. 44 E Alm `A „.,i !. ,ii., 4‘ ',..47rn: 4..."''.. C T A ;k •6 d te ♦t, '•••;'-'1'."`"•.',"0 sr It yi i 11 I 1 I LAND SURVEYORS ... , ,.. -�,-,., it` � ��. _ ._. _._, +.",� 1 i- k7.;tl i2 Y: h l ,Serving all o/ i'lorrda tea:. PROPERTY ADDRESS: 318 ROYAL PALM DRIVE ATLANTIC BEACH,FLORIDA 32233 SURVEY NUMBER: FL1410.2386 FIELD WORK DATE: 10/28/2014 REVISION DATE(S):(REV.o to/25/20141 FL1410.2386 'I:'BACK INFORMATION SHOWN ON PLAT,NOT VERIFIED. ,I APPEARS TO BE SERVICED BY CITY WATER AND SEWER. BOUNDARY SURVEY I i.`.,_r OWNERSHIP NOT DETERMINED. DUVAL COUNTY I t 24., 1.01 )5 'r t 51..v:25 � 30.0' ropir 1 I ` 1 N 52°41'23°,E•93 (P):