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358 ROYAL PALMS RFNC24-0077 BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY / City of Atlantic Beach Building Department PERMIT# RF�C Z4'(:)()-77 _) 800 Seminole Road, Atlantic Beach, FL 32233 information required to process .,." D7wPhone: (904) 247-5826 Email: Building-Dept(Wcoab.us Job Address j`-ecZ /A1L-pA1Aw4.S RE# 17/712- 000c) Legal Description 31 - I(,; \7-g$--.. .16 'p/-P O :Pr0P 'YA/-Pat,wlS' Ch-i ZA w1-20 LPI Z-" --- Valuation of Work(Replacement Cost) 7° 75— Heated/Cooled SF Non-Heated/Cooled SF *Class of Work: ❑ New ❑Addition ❑Alteration ErRepair 171 Move ❑Demo ❑Pool fl Window/Door • Use of existing/proposed structure(s): ❑Commercialtesidential • If existing structure, is a fire sprinkler system installed?:❑Yes❑No •Will tree(s) be removed in association with proposed project? ❑ Yes (Must submit separate Tree Removal Permit) 0-No Describe in detail the type of work to be performed: T,C 1^/(J /C CO P eN(✓G-1 \,-)3-1-A(4— NE;(A7 t,0 s r-C V 1•-' y L ' " -/.- Floridada Product Approval# (For multiple products use Product Approval Information Sheet) Property Owner Information Name 77-6-,..1/1/4//5 y,C--T-.t{. Phone 97L/ Z 9/ - 9A-S- ) Address 3) '120.-/A I--'PA 4._r--)5 City /JTL4.-rZ'kC (�6.fr , State Fe._ Zip ,ZZ33 Email Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company 0485 47--ic,z:::SLC} Phone 9,(777/ 7287-1T Address (340 I'I.i i a--/P ��pi City iAciGSc7s-c (...c-'-- State pc__ Zip a ZZ?3 Qualifying Agent )0 "OlhlZi_,15r- State Certification/Registration# Email ` &.0ACA-�5 F - 4/ . 1 Job Site Contact Number 90-( `7D$* 77S'i Worker's Compensation Insurer ,&Jii1 Q ci OR Exempt [IIExpiration Date / i (. Z S 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. "'E_: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 ATTOEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 7 owi 7c) i\ ________ .A.,_7,..,. ._:___ . (Signature of Owner or Agent) (Signature of Contractor) Signed and sworn to(or affirmed) before me this 3 dayof Si ne land s orn o or a ,Z k g d ��' off r�ec��t"efore me this ,�j day of S,,,.J f, . , 3604.1 by )'V1 h S ' . • --s ,.J , aoaq by , _ . Signature of Notary ,LQt, Signature of Notary .114- cti- Ja A.A.A/ [ I Personally K wn OR PC] Produced Identification 'Personally Known OR [ ] Produced Identification Type of Identification: IDL a, •a Type of Identification: of Notary Pubic State cif Fbdda 4 Jessica A Do quist P Je$SJca A (101gUIS1 My Commission HH 142217 • My Commruion HH 147217 arw Expires 06/14/2025 ‘rrr wi Expires 08/14/2025 ' S�yLJf.�. F e n c e A e n U n1 Updated 03/07/2024 City of Atlantic Beach Building Department o, i. , / 800 Seminole Road, Atlantic Beach, FL 32233 _,c)tomPERMIT # Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: Date: , sg 2oy,'L era&r►-i5 6 - y- z 4/ Property Type: Lot Type/ Features: 1 Residential L4.15ne 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): E Wood (I4Four Foot(4ft) ❑ Chain Link C2/Six Foot (6ft) J2/Vinyl ❑ Other E 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? Zles (must submit separate Revocable Encroachment Agreement) ❑ 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. ''► �; REVOCABLE ENCROACHMENT AGREEMENT S City of Atlantic Beach **ALL INFORMATION i'0,.. ! 800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY \ 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 —Pent')14 V e ' 7-ft 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 as -FE'"C— jeU< . .1 Any facility maintained, repaired, erected, and/or installed in the exercise 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 35-8' AL -PA t..1--, . • 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. it iiu." / . A Date U2/5/ay Property Owner/Agent(signed in presence of Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL _ The foregoing instrument was acknowledged this 5 day of 76 A)f.- , 20 v `i , by I k 1 S . v Q ( 7i (printed name of Signer), who personally appeared before me and acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. Public State JeADolquisd Florida• 4! • My Commission 111.1142217 Noto di Expires 06/142025 / ..'l_..... _jai' 0./ — Department Approval: Si ature of Notary Publ 1, State of Florida [ ] Personally Known j4 Produced Identification (Type) Public Works Department Date Revision Date:05/09/2023 '! ♦ # r '^fir '`•„/� �,°ti.Y t..l1j .. W sµt ti;a 4Z4 eV .q�, raa1 1 .'- ''ti MAP SHOWING BOUNDARY SURVEY OF LOT 20, BLOCK 25, REPLAT OF PART OF ROYAL PALMS, UNIT TWO-A, ACCORDING TO PLAT THEREOF, AS RECORDED IN PLAT BOOK 31, PAGES 16, 16-A THROUGH 16-0, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. CERTIFIED TO: 80 SER PROPERTIES,AMANDA R. BOWSERLC GOLDEN DOG TITLE AND TRUST ROYAL PALMS DRIVE (60'RICHT Of WAY) S 07'16'02" E 80.65' (PLAT) BLOCK CORNER RNE 727.92'(PLAT) S 07'08'27" E 80.71' (MEASURED) D.7,--1 a r I. . • a lei ' 9 5 6-A mari Q& t3.S J VI ?-A�� T-)n .-w 9, 25'BUILDING .�Q. _ flESTRIC110N UNE v� ..19.8' UA O �.__ 17.0' O A tJJ d LV m I it D A, V 9 rn t-o'TA l.L -4 LL1 7 -7�COENTRY 20.0' M s.d •D• LOT 19 LOCK 25 o+') to TP�� 01 • ' 3 Q N 3 as 7B r ONE STORY LOT 21 MASONRY cia 10 i' BLOCK 25 y a MNn POSTED 358 • Ln Ln S3 4b1 SHED 1 7 ns' Nm b� L - ' D.2' (-i WNn 17.6' •W P 10 BALL n N • I 24.8' LOT 20 N 4 21,8' ID �--COVERED — BLOCK 25 .. c0 NN WOOD DECK l�j. Z 1x7 , 24.6' / ZCOVERED a -— _ PATIO 7..°,y U—_ � 10'EASEMENT FOR •.7' 24.6' ..0' DRAINAGE& mows- - 1,0' .4 ' N 0718 02" W 80.71' (MEASURED) ' N 07'16'02" W 80.65' (PLAT) LOT 5 LOT 6 BLOCK 25 BLOCK 25 E 7e7 r LEGEND: -0-- - WOOD FENCE —K— - CHAIN LINK FENCE OD- CONCRETE O-SET t/2'REBAR STAMPED PSM/81.6 •-FOUND 1/2'IRON PIPE NO IOENTIDCATON (UNLESS OTHERWISE NO1E0) ■.9'.4-CONCRETE MONUMENT PC . POINT OF CURVATURE PRG - POINT OF REVERSE CURVATURE A/C . AIR CONDITIONER PT . POINT OF TANGENCY PCC . POINT OF COMPOUND CURVATURE NOTES: REVISIONS • 1. BEARINGS ARE BASED ON THE PLAT BEARING OF NBz43'5.6"_€____ALONG THE NORTHERLY BOUNDARY LINE OF SUBJECT PARCEL. DATE DESCRIPTION 2. DY GRAPHIC PLOTTING ONLY THE CAPTIONED LANDS LIE WITHIN FLOOD ZONE___.K____. AS SHOWN ON THE NATIONAL FLOOD INSURANCE MAP DATED NOVEMBER 2.2016, COMMUNITY NUMBER 120077,PANEL_Q&Q.&,1_ 3. THIS SURVEY REFLECTS ALL EASEMENTS&RIGHTS OF WAY AS PER RECORDED PLAT Jt/OR TIRE COMMITMENT OR OTHER DOCUMENTS PROVIDED BY CLIENT.IF SUPPLIED.UNLESS OTHERWISE STATED,NO OTHER RILE VERIFICATION HAS BEEN PERFORMED BY THE UNDERSIGNED. .`.- 4. THIS SURVEY IS NOT VALID WITHOUT AN AUTHENTICATED ELECTRONIC SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL. JOB # 39762 3 DATE OF FIELD SURVEY: 06-12-20 I SCALE: 1" = 20' Ray Thompson CERTIFICATE ___ __ I HEREBY CERTIFY MAT THIS I'c .WA DE UNDER MY RESPONSIBLE CHARGE r SURVEYING, Inc. ANO MEETS THE STANDARD e•I^'. w..t., T FORTH 8Y THE FLORIDA BOARD OF PROFESSIONAL SURVEY.....•.:E R3 APVER* .`AP R 5J FLCR:DA AOMIMSTRATVE CF ANT ram.TON yd. ORIDA STATUTES. (Going the DISTANCE for Youl e,�6 '(� 1825 University Boulevard West — _*I w/ / � .-c_......... Jacksonville,Florida 32217 RAYMOND THOEPS+lk II (Phone)904-448-5125 REGISTE`F�1 SURYEAY3DNIND (It PER H 6146 .. (Fax) 904-448-5178 STATE OF + IDA LICENSI.:04' LOS No. 7469 LAND SURVEYS 0 CONSTRUCTION SURVEYS IIugvE 6DIV1510NS