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Permits 606 Aquatic DriveCITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number Property Address Application type description Property Zoning . Application valuation . ---------------------------- Application desc Eft fence replacement ---------------------------- 09-00001066 Date 9/04/09 606 AQUATIC DR FENCE PERMIT TO BE UPDATED 0 -------------------------------------- -------------------------------------- Owner Contractor ------------------------ ------------------------ BENNETT OWNER 606 AQUATIC DRIVE ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit FENCE PERMIT Additional desc 6 FT FENCE Permit Fee 35.00 Plan Check Fee .\ .00 Issue Date Valuation 0 Expiration Date 3/03/10 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/'05-'06 SUPPLEMENTS. 2007 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *ALL FENCES OR ENCLOSURES OF LAND SHALL BE SUBSTANTIALLY CONSTRUCTED. *SCHEDULE FINAL INSPECTION ONCE FENCE HAS BEEN COMPLETED. PERMIT AND APPROVED SURVEY MUST BE AVAILABLE FOR FINAL INSPECTION. approved with the signing of a revocable encroachment permit; homeowner needs to stay at least 5' off the sewer main. ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35.00 35.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 35.00 35.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. -S.:>>~~f,,,,. City of Atlantic Beach ~~ ~ °~ri}, Building Department ~' ~ 800 Seminole Road ~/(~/~ V '""' s' Atlantic Beach, Florida 32233-54 - $ ~' Phone (904) 247-5826 Fax (9 j-5845 ~~~ "•~"Lp;;~Jr E-mail: building-dept@coab.us City web-site: http://www.coab.us .APPLICATION NUMBER (To be assigned by a Build/i~ng/,,De ar D .~ /v U/ Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: ~~ ~(. ~~~ V~ ~pp ~ Applicant: ~ ~(~ 1yC Cam- Project: ~ De meat review required Yes No Build• tanning & Zon~ ree Administrator ub• tic Utiliti Public Safety Fire Services .._ ... Review fee $ - - - ~-, Dept Signature ~.~.. Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: ^Approved. ]Denied. (Circle one.) Comments: BUILDI PLAN G & ZONING Reviewed by Date` EE ADMIN. Seco d Review: Approved as revised. ^Denied. BL WOR S Co meats: P BL C T IES UBL SAFETY Reviewed by: /~ Date: ~3-" / F E SERVIC Third Review: ^Approved as revised. ^Denied. Comrvaents: Reviewed by: Date: Revised 05/14/09 Brooks, Nancy From: Kaluzniak, Donna Sent: Monday, August 17, 2009 1:33 PM To: Brooks, Nancy Subject: RE: application for fence at 606 Aquatic Drive Attachments: Revocable Encroachment Permit REV10-08.pdf Nancy, we will need them to sign a revocable encroachment permit, and they need to stay at least S' off the sewer main. From: Brooks, Nancy Sent: Monday, August 17, 2009 8:46 AM To: Kaluzniak, Donna Subject: application for fence at 606 Aquatic Drive Donna, the application, # 09-1066, for the above address was denied by Public Utilities. The homeowner wants to know if there is a waiver (for exception) that she can sign. Apparently there was a fence there when she purchased the property and it was allowed because the previous owner signed a document. OR can you please locate the sewer main so the owner can install the fence just inside the lines? Thanks, N~uicy Brooks Buikiuig Deparhnent City Ot~ Ad~mtic Beads (904) 247 :5826 nbrooks(cz~coab.us R.O.W. Permit Attachment of R.O.W. Permit # issued , 200 Owner's Name: Property Address Subdivision Lot # /Block #: R.E. #: for Atlantic Beach, FL 32233 f~r~n~~i °~TeP.Ro~un ~3c°nnc'~ ~ r ~O~ ~~ua~iL ~~ ~" In~f}C.., ~~~ ~"L X2233 REVO~:'ABLE ENCROACHMENT PERMIT T IS REVOCAB ENC tOACHMENT PERMIT, issued on this ~~ day of 200~by Atlantic Beach, Florida, a municipal corporation organized and existing un er the laws of the State of Florin: a, hereinafter referred to as "CITY" and Ra/1 f?, ~~°n I1p~f of Atlantic Beach, Florida, hereinafl ~r referred to as "USER". %Plz~'D/yrl /~~~ nN-~~ WITNESSETH: That the CITY does hereby gra t the USER permission on a revocable basis as described herein the right to enter upon the property of ~ -e City of Atlantic Beach for the purpose as described in the City of Atlantic Beach Right-of-Way/Ease~i .ent permit numbers noted above (copies attached). This work is generally describe as: Any facility maintained, repair: d, erected, and/or installed in the exercise of the privilege granted remains subject to relocation or ren~ oval on thirty (30) days notice by CITY to the USER, said notice to USER shall be given by certi ed mail, return recei t requested, to the following address: The depositing of said notice of cancellation in the United States mail shall constitute the notice of cancellation and the burden is upon :JSER to keep the CITY informed of USER's proper address. The USER shall promptly makf any and all necessary repairs to any facility erected or maintained in the exercise of the privilege herein ;ranted and shall at all times maintain said facility in good and safe condition. In the event it is necessary for he CITY or the City's approved representative or other franchised utility to enter upon the above-des•: ribed property of the CITY, the USER shall replace at the USER's sole expense, any and all materia~ necessarily displaced during the action of maintaining, repairing, operating, replacing, or adding to o?~ the utilities and facilities of the CITY or franchise utility provider. The facilities allowed by the peg •mit shall meet the current requirements of the City Code, Building Codes, Land Development Code, a~~ i all other land use and code requirements of the CITY, including City Code Section 19-7 (h) which Mates "Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but ~i ust be replaced with smooth concrete left natural in color so that it matches the existing and adjoining ,dewalks." Page 1 of 2 The USER, prior to making z written approval from the City of USER shall, at the discretion of the within thirty (30) days after the day This permit shall insure to thy: successors and assigns. ty changes from the approved plans and/or method, must obtain Atlantic Beach, Public Works Department, for said change. The CITY, be requested to submit as-built drawings showing the change ~f completion. benefit of, and be binding upon, the USER and their respective USER shall meet the terms and ;onditions of this permit and to all of the applicable State and CITY laws and/or specifications, to incl>.~ ie utilities locate requirements and use limitations/requirements of public rights-of--way and other pulp lic 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 ire hereby assumed by the USER. DATED and SIGNED this ~ day of t P ~~ 20(~ 1~~ roperty Owner (to be signed in resence of the Votary) STATE OF FLORIDA COUNTY OF DUVAL On this ~ day of ~ 8~ ~. , 200 personally appeared before me, a Notary Public in and for said Co my and State, the property owner of ___, Atlantic Beach, Florida, known to me to be the person(s) de ed in and who executed tl- ;foregoing instrument; who acknowledged to me that he or she xecut th same fre~nd~6olurr: trily and for the uses and purposes therein mentioned. Notary Public CITY OF ATLANTIC municipal corporation: .~~~~~~~~,, SHIRLEY L. GRAHAM ~' °` Notary Public -State of Florida - • , • _My Commission Expires Feb 14, 2010 y~ °P `•~ ';'~ ~°~ Commission # DD 518533 I~''~ABoaded By National Notary Assn. Approved ~ /~ Ricky L. Ca er, Public Works Di t actor For Permits where city sidewalk is npacted, City Manager approval required: Jim Hanson, City Manager Page 2 of 2 ,.;-`-A"`~'r'~ .~ CITY OF ATLANTIC BEACH "~ ~ ~s~ 800 SEMINOLE ROAD, ATLANTIC BEACH, FL 32233 s OFFICE: (904)247-5826 • FAX NO.:(904)247-5645 ti '" ' BUILDING-DEPT~COAB.US \r~~•`::,~;. Bl11LDING PERMIT APPLICATION 09- .. L.L.. _I_ I _ I DUVALCOUNTY 1."JOB ADDRESS: 2. VALUATION OF WORK: 3. SO. FT. UNDER ROOF ~v v l , 4. LEGAL DESCRIPTION: 5. CLASS OF WORK: fi: US F STRUCTUREi ^ NEW BUILDING ^ DEMOLITION ESIDENTIAL SUB DIVISION BLOCK LOT ^ ADDITION ^ CONVERTING USE ^ COMMERCIAL _ _ DESCRIPTION OF WORK: 7 ^ ALTERATION ^ ACCESSORY BLDG. 8. FIRE SPRINKLER: . ^ REPAIR ^ POOL /SPA ^ YES ^ NIA /~ f~ C (~ ~ ~~ ^ MOVE ^ OTHER ^ NO PROPERTY OWNER: CONTRACTOR: , ARCHITECT /ENGINEER: 9. NA ME: 15. COMPANY NAME: 23. COMPANY NAME: t p ,p + ~ ~ ^ y~ / ~ ,c1 ~ ' ~ ` ~` ~ ~ ~ J ~ LICENSEE NAME: 24 C~. \ (/~C j3 e n n 16. NAME: . ADDRESS: 10 17. STATE OF FLORIDA LICENSE NO.: 25. STATE OF FLORIDA LICENSE NO.: . i~ra +i c. T~ r~ ~ v ~ C ; ~ D 16. ADDRESS: 26. ADDRESS: ~ I an~.~~ch 3ZZ33 11. PHONE: )-/~/µC' 12. FAX NO.: 19. OFFICE PHONE: 20. FAX NO.: 27. OFFICE PHONE: 28. FAX NO.: ~a ~ ~, 13. CELL PHONE: 21. CELL PHONE: 29. CELL PHONE: 14. EMAIL ADDRESS: 22. EMAIL ADDRESS: 30. EMAIL ADDRESS: r mrs bcnn e r~ . nN ~ FEE SIMPLE TITLE HOLDER: BONDING COMPANY:" MORTGAGE LENDER: " (IF OTHER THAN OWNER) 31. NAME: 33. NAME: 35. NAME: 32. ADDRESS: 34. ADDRESS: 36. ADDRESS: 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 laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, Tanks, Air Conditioners, etc. 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. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official, as required by law. ~ 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. OWNER or AGENT CONTRACTOR gent, Power of Attorney or Agency Letter Required) (If A (Qualifier OMy) D Signed:- Date: ~ '3 a ~ YT ~ Signed: Date: Be me this day of , 2009 in the county of Before me this day of , 2009 in the county of Duval, Stat ~d~ha ~ e~onally app ~ L Duval, State of Florida, has personally appeared n herin by himself /herself and a s that all statements and declarations are herin by himself /herself and affirms that all statements and declarations are true and accurate. true and accurate. ~ Notary Public at Large, State of ~, County ~ Notary Public at Large, State of ,County of ^ Personally Kno ~~ ~ ^ Personally Known ^ Produced ntification - ^ Produced Identfication - Notary Sig ,.: Notary Signature: . ~ '<,-•• to Ic~.~tate~r riornoa • ; » • EMy C mission Expires Feb 14, 2010 ;~ ~ C mmission # DD 518533 ••~0;,~ ~"'• Bo ed By National Notary Assn. BLDG01 Pemit Application BI d1 _0 K~L 10 flit MAP SHOWING BOUNDARY SURVEY OF /~~D~' ~ DTS /~'' .~ .git/O /3-~I, .qS S~YD~t/~ Div ~lAP 4~ ,4c; >uA~ic G~~DE,vs . AS RECORDED IN .PLAT 900K ~ , _ PiAOES ~~ ~''~ OF THE CURRENT PUOLIC RECORDS OF DUVAL CO.. FLA FOR ~ ~° ~!///7YC~ CA~PDENS d~Y,/T yE,yru.QE KOTE_ AE4RING .DATUM SHOWN HEIIEON ARE 9AlED ON THE A 0'VE MEN ZONED RLAT. .vo>E SEE A~7"ACHEn LE6~1L 7~[',P/P~i~/ 4 .n O gyp, 1 ~A `~t,f ~! ,~ ;y _ V~ ti~ ~g ,~ ~~ 0 1~ ~a I `. / 'P is fySE `V '~%..,~F`''~ /''cam' ~ r/,'~ -ter q ~~•" o ~~' 1ti. ~ ~~ ~,,,,~ P 6~•,~ /~ ~ ~ . ~,0 ,' ~ I . .~~~~ ems- y.y ~k. ' `' ~`' s ~ ~ `.16~~ . , . . cs~. , .~~~ .~., . ~ ~ ~. ~ ~ ~,• •~ .. ~~ ~olF~~ti i ~~ . a C a 1 ch '{ : ~ u~' N ; y r ~ ; w '~ ~r~~ •• ~ ~ M 'V~~J c~~~r ' ~ O ,w ~ r ,MPo ~ : ~ N ~ n t ~ a til~~~ ,~ ~ v ~ ~ t ~~N~~v 1 ~o ~~ ~, .o `.;~w ~,,,. a ~ ~ ! ~~~, -- ;: 1 ~ , ~ y ~, J ~ ,o ~N ~'- - ~ ~~. ~y . ~e~ ~`~. 1 S S fl~~ V ~ CUr~ A rte. f: ~, Z S » ?), Q / S 8 •. ~ °' ..~. ~~: ~~~, ~J ~V ~ ~~ c •~ , a ~~ ~; ,~ ~; O . . '3a ~,'J1G0 Showman, Lisa To: mrmrsbennett@r2t2.net Cc: Kaluzniak, Donna; Boyd, Nancy Subject: Building Permit Application for 6' fence Mr. & Mrs. Bennett: Public Utilities has denied permit application #09-1066 for the 6' fence at 606 Aquatic Drive. The following comment applies: "Revise to keep fence out of utility easement. There is an existing sewer main in the easement where the fence is shown." Please submit revised plan to the Building Department at your earliest convenience. If you have any questions please call 247-5826. Thank you. Lisa Showman Administrative Assistant BP251I03 CITY OF ATLANTIC BEACH Application Tracking Action Log Inquiry Application 09 00001066 Address 606 AQUATIC DR Application type FENCE PERMIT Revision/Path/Step/Seq/Agency: A 01 00 PU PUBLIC UTILITIES Action date 8/05/09 Action type FR DISSAPPROVED - 1ST REVIEW Action by LS LISA SHOWMAN Time spent .00 Date/Time/User added 8/05/09 15:05:50 LSHOWMAN Co~aents Revise to keep fence out of utility easement. There is an existing sewer main in the easement where the fence is shown. _, .~,~._.. Press Enter to continue. "~~~~ F3=Exit F8=In/Out Status F~2=Cancer ~~' 1 ~~\ ==~, ~~~'" ,.~ ,~ /~:.., V i _..t ~"xF ~. ~""--~ Print 8/14/09 16:34:24 Bottom •i~:~~~/;;,,_ City of Atlantic beach ~~ ~~ ~ `•`SS Building Department ~' i 800 Seminole Road .. - .. .r ""''' ' r' Atlantic Beach, Florida 32233-5445 Phone (904) 247-5826 Fax (904) 247-5845 ~• "~~o;tl~%' E-mail building-dept@coab.us City web-site: http://v/ww.coab.us APPLICATION NUMBER (To be assigned by e Building De artment.) D~~ /o~~ Date routed: ~ 2.~ ~ APPLICATI®N RE!/IEW AND TRACKING 1=0RM Property Address: U~~ (,~ ~r~ v~ ~-pQ Applicant: ~)11~~ r~ ~ Project: c De ment review required Yes No Build' tanning & Zo ' ree Administrator ub' tic Utiliti Public Safety Fire Services .._... Review fee $ .• -` ~ Dept Signature ~ ..... Other Agency Review or Permit Required Review or Receipt of Permit Verified By Dete Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department f=irst Review: [proved. ^Denied. (Circle one.) Comments: BUILDING NING & ZO TREE ADMIN. PUBLIC WORKS PUBLIC UTILITIES PUBLIC SAFETY FIRE SERVICES Reviewed by: ~~d,P~.. Date: G~ 7'Z ~}~ d' second Review: ^Approved as revised. ^Denied. Comments: Reviewed by: Ti~ird Review: ^Approved as revised. ^Denied. Cam~ents: Reviewed by: Date: Date: Revised 05/14/09 f r~~J~ ~~ :J;. ,~ } ~:;~~~~ -r_J r:l J CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD, ATLANTIC BEACH, FL 32233 OFFICE: (904)247-5826 ~ FAX NO.:(904)247-5845 BUILDING-D EPT~ C OAB. U S BULL®ING PERMIT APPLICATIt~RI _. _ 09- I I I I I DUVALCQUNTY "1. J06ADDRESS: 2. VALUATION OF WORK' 3. SO. FT. UNDER ROOF (p c ... ~ ~ CJ U U 1 , 4. LEGAL DESCRIPTION: 5. CLASS OF WORK: fi': US F STRUCTURE ^ NEW BUILDING ^ DEMOLITION ESIDENTIAL LOT BLOCK_ SUB DIVISION ^ ADDITION ^ CONVERTING USE ^ COMMERCIAL 7. DESCRIPTION OF WORK: ^ ALTERATION ^ ACCESSORY BLDG. 8. FIRE SPRINKLERi /' d~ G ~ ~ ~ ^ REPAIR ^ POOL /SPA ^ YES ^ NIA ^ MOVE ^ OTHER ^ NO PROPERTY OWNER: CONTRACTOR"r ARGHiTECT ! ENGFNEER: 9. NAME: 15. COMPANY NAME: 23. COMPANY NAME: l~ /jJ 1 / ~ ~ ~~ ~ ~ ~ ` ~ ~ ~' ` V `~ ' fi t ~~nn~ 1 . NAME: 24. LICENSEE NAME: 10. ADDRESS: ~ + 17. STATE OF FLORIDA LICENSE NO : 25. STATE OF FLORIDA LICENSE IVO.: i2 i C Co C~ fa ;~ ~ i.~U 18. ADDRESS: 26. ADDRESS: f4-~ I a n -~,~ ~~ c~ 3 zZ~.3 11. O PHONE: ~-/-~ry~' 12. FAX NO : 19. OFFICE PHONE: 20. FAX NO.: 27. OFFICE PHONE: 28. FAX NO.: ~' 2 t °~ 13. CELL PHONE: 21. CELL PHONE; 29, CELL PHONE: '" 14. EMAIL ADDRESS: 22. EMAIL ADDRESS: 30. ENTAIL ADDRESS: mr mrs berm e' n rat • nN t EE SIMPCH TITLE HOLDER: __:_.- (IF OTHER THAN OVMER) BONDING COMPANY: ... - - MORTGAGE LENDER: 31. NAME: 33. NAME: 35. NAME: 32. ADDRESS: 34. ADDRESS: 36. ADDRESS: Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or instal{ation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, Tanks, Air Conditioners, etc. 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. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official, as required by law. *~ 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. OWNER or AGENT CONTRACTOR (If AA g®nt, power of Attorney or Agency Letter Required) (Ouslilfer Only) J Signed:-- UT ~ Date: ~ ' ~ '- ~ Signed: Date; Bef~ me this day of , 2009 in the county of Before me this day of , 2009 in the county of Duval, Stat 'da, ha ~ eFSOnally app Duval, State of Florida, has personally appeared ~r L n~~ herin by himself /herself and a s that all statements and declarations are herin by himself /herself and affirms that all statements and declarations are true and accurate. true and accurate. ~ N ~ ~L otary Public at Large, State of , County Notary Public at Large, State of ,County of ^ Personally Kno ~ ~ ^ Personally Known ^ Produced nfification - ^ Produced Identification - I~otary Sig„ ~~•; Notary Signature: ~' , to rlonoa • : : •My C mission Expires Feb 14, 2010 ~"" ~~ C mmission # DD 518533 ~9T ""' ° ~^`" Bo ed By National Notary Assn. ELDG01P~~nitApplicationGl ~I ~D: ci,o10- Nom[ 10 !1!! 1 MAP SHOWING 80UNDARY SURVEY OF ~'~~r4~' ~ DTS /2' ~~ .gitlo /3-~I, .q.S SHOI~!/it/ Div MAP d.~ .4c; l~t9r/C ~A~~Eit/S _. AS RECORDED IN .PLAT BOOK ~ . _ PAOEg ~/~~'A OF THE CURRENT PUBLIC RECORDS OF DIIVAL CO., FLA FORS ~? OUArit CA~F'OENS d44vT vE,yT[/,B~c NDTE AE4RING DATUM SHOWN HEl it£ON ARE BASED ON THE A 0'VE MEN CONED PLAT .vorE SEE Ar7'~C//En LE6~f L ~e~c,PiPT~a~. ~' ~".s. ~ ~ ~ /S `r~sE' A N '~ ity of Atlantic Beach ~~"~~'•s ~;,~~~~ ~ Planning a Wing Department "''~'.ir} - .~~ i ~ This approval v fiance whh applicable • zoning, subdivis nd other local land 9 ~ _ development regul tions but does not constitute f,~. ~ p~ , 9'~ approval for the issusnce of permit. Compliance ~ ~ a~ with Florida Building Code and all other applicable ' ~ ,'~, local, State and Federel permitting requirements ~ P~ ; ~d ~ moat be verified by signature of the Cky of Atlantic ~ yr;; ~ la t3each Building prior to bwanca of • • fl . 5t' f BulidNtg Permit. p ~,~,' y' ~oo~ l~•A ;, °~ ~' ve ma ``, ,, L ~ y' ~, - • `,bed ~ 1b/ ~'~~~tl Y ° ~\ ~!. Z 3 t7~o Is. fl ~,~ ~ ,~.~ ~ w ~ ~'. / ~ ~ ` .. 1 P~ ~ b ;; a _ ~: ~. ~'as2, 3: ~ On ~ ~ c. ' O ~y ` ~ ~V > ~•~ ~ O ~^ ., ; • •~ ~ ~ ~ ' ~` ~~ ~"""1 y ~i' p ~ 'i 1;~ ' ~ O ~ ~. --- - - `~ A~~ __ _.. _. __ .-_.. .~ .. ~:'~}.L .- -- - -- 1~~. tom'. wi ~ ~~ T ~ s .~' N . ~s. q9' _~~~, ~,,.~ S fly'/ ~~ R j1 1 ~ F '~ p ~ .. ,.~ .. y~ .... ... .. e `7f~~ ~ 1;'~ • f '~V.~• f 1j~4d1st>KsiiS;Ya~ ~{ q .w..N .T1+1~ V) ~,s.:a•~1;.~,,... City of Atlantic 03each ;;~ ° ~: ~° ~;~ Building Department ~ `-~ 800 Seminole Road ' ""`" ~' Atlantic Beach, Florida 32233-5445 J• Phone (904) 247-5826 Fax (904) 247-5845 -- ~.! ~;;~ jr E-mail: building-dept@coab.us City web-site: http://www.coab.us .APPLICATION NUMBER (To be assigne ~y~ie~Bui~~ g Department.) Date routed: ~ Z.~ __Q~ APPLICATI®N REVIE~111 AND TRACKING I=ORM Property Address: ~~LO f~u. ~'~~~ V~, ~~pp Applicant: ~11JC Cam- I Pr®ject: ' De meet review required Ye No Build' tanning & Zo ' ree Administrator ub' tic Utiliti Public Safety Fire Services Review flee $ . ,,,. . Dept Signature. ,. ..: Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department f=irst Review (Circle one.) Comments: BUILDIN PLANNING & ZONING TREE ADMIN. PUBLIC WORKS PUBLIC UTILITIES PUBLIC SAFETY FIRE SERVICES pproved. ^Denied. Reviewed by: Date: .~~ O Second Review: ^Approved as revised. ^~nied. Comments: Reviewed by: Date: Third Review: ^Approved as revised. ^Denied CQO~oments: ~~eviewed by: Date: Revised 05/14/09 -S y ~~~:r,,~,. City of Atlantic Beach `~~ r `~ `-`-~~~fl Building Department •~ 800 Seminole Road "°"`' s' Atlantic Beach, Florida 32233-544 J - Phone (904) 247-5826 Fax (904) ~,=o;aar E-mail: building-dept@coab.us City web-site: http://www.coab.us ~E,„„ APPLICATION NUMBER y`/,C (To be assigned by e Building De ar ~ %~~ Q ~ ~o(o~ ~~ n Date routed: / 2~ ~ APPLICATION REVIE~IV AND TRACKING FORIWI Property Address: (~~ u. ~~~ irk Applicant: ~ ~11y~ f'~ Project: ~ De ment revievor required Yes No Build' tanning & Zo ' ree Administrator ubl' tic Utiliti Public Safety Fire Services _.__. Review fee $ ::::..... _ Dept. Signature .. ..:. ®ther Agency Review ®r Permit Required Review or Receipt of Permit !/erified By ®ate Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATI®N STATUS Reviewing Department First Review: ~jApproved. ^Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING TREE ADMIN. PUBLIC WORKS PUBLIC UTILITIES PUBLIC SAFETY FIRE SERVICES Reviewed by: ~. ~ Date: ~~~! Second Review: ^Approved as revised. ^Denied. Comments: Reviewed by: Third Review: ^Approved as revised. ^Denied. Coo~a~eo~ts: reviewed by: Date: gate: Revised 05/14109 //,~; ` t' ~ ~ CITY OF ATLANTIC BEACH -~ a t~;i+ 800 SEMINOLE ROAD, ATLANTIC BEACH, FL 32233 z OFFICE: (904)247-5626 ~ FAX NO.:(904)247-5845 `~~`i,,;; ~ BUILDING-DEPT(a1C0AB.US ~'?r~~~H BUIL®ING PERMIT APPLICATION __..... . 09- ~- -- I ..._ I . _. L ..-I ©UVALCQUNTY 1. JOB ADDRESS: 2. VALUATION OF WORK: 3. 50. FT. UNDER ROOF (A c .... ~~ I, d U U 4. LEGAL DESCRIPTION: 5: CLASS OF WORK: 61 US F STRUCTURE: ^ NEW BUILDING ^ DEMOLITION ESIDENTIAL LOT _ BLOCK_ SUB DIVISION ^ ADDITION ^ CONVERTING USE ^ COMMERCIAL >. 7. DESCRIPTION OF WORK: ^ ALTERATION ^ ACCESSORY BLDG. B. FIRE SPRIIJKLER[ pp //~~ ' ~ ~~ ^ REPAIR ^ POOL /SPA ^ YES ^ N/A ~ G l.r C... { ^ MOVE ^ OTHER ^ IVO PROPERTY OWNER:; CONTRACTOR':: ARCH{TECT/ENGINEER:. 9. NA M E: 15. COMPANY NAh4E: 23. COMPANY NAME: ~ T(~ ~ ~ ~ ~ ~ / ~ 1 ,Ct n ~t•~-' \ (.~C. j U J'~ 18. NAME: 24. LICENSEE NAME: ~3~ nn 10 ADDRE SS: 17. STATE OF FLORIDA LICENSE NO.: 25. STATE OF FLORIDA LICENSE NO.: . jj ~~11 ~ ~ ~1U ~~ ~. ~ ~~ ( o 18. ADDRESS: 26. ADDRESS: f4-EI an-~-,~~f3cti 32z3.3 11. O PHONE: J-Fdfyt~ 12. FAX NO.: 19. OFFICE PHONE: 20. FAX NO.: 27. OFFICE PHONE: 28. FAX NO.: ~S' 2 - t7~ 13. CELL PHONE: 21. CELL PHONE: 29. CELL PHONE: 14. EMAIL ADDRESS: 22. EMAIL ADDRESS: 30. EMAIL ADDRESS: frmr mrs been ~ ~ rat . nt' t' EE SIMPLE TITLE HOLDER: ~ BONDING COMPANY: MORTGAGE LENDER: (IF OTHER THAN OWNER) - - .. - 31. NAME: 33. NAME: 35. NAME: 32. ADDRESS: 34. ADDRESS: 36. ADDRESS: Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or instal{ation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenczd within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumtaing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, Tanks, Air Conditioners, etc. 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. I will not occupy or use the referenced building or any part therof, until all inspections are tingled and prior to obtaining a certificate of occupancy or completion issued by the building official, as required by law. ~ 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. OWNER or AGENT CONTRACTOR gent, Power of Attorney or Agency Letter Required) (If (OualMer Only) A -- VY~ ~ 'I. Date: ~ ~ " ~ Sign ed: Signed: Date: ~/ (/ Befdt~me this day of , 2009 in the wunty of Before me this day of , 2009 in the county of Duval, Stat 'da, has pe ovally app ; ~'' ~ rr~~yh ~n n` ~ l ~ Duval, State of Florida, has personally appeared herin by~/ herself and a s that all statements and declarations are herin by himself /herself and affirms that all statements and declarations are Prue and accurate. true and accurate. ~ Notary Public at Large, State of ~, County ~/ Notary Public at Large, State of ,County of ^ Personally Kno L ^ Personally Known ^ Produced ntificatlon - ~Y ^ Produced Identification - Notary gig Notary Signature: __ ~ ~ » ~ My C mission Expires Feb 14, 2010 '`"~" ""'-+ ~ C mmission # DD 518533 Bo ed By National Notary Assn. BLDG01 Femit Applicztion BI ~I ~D: ~/1 z0u Kam[ 10 ilia ~1 MAP SHOWING BOUNDARY SURVEY OF ~~7'p~' ~ DTS /c' ~,a .gitl0 /3-~I, ~S Sy0l~l/~t/ Dit/ Mf~P D.~ .4c; ~T/C ~~•~~E~t/S . AS RECORDED IN -PLAT 6O0K ~ , _ PAGES ~~ a'~ OF THE CURRENT PUSI.IC RECORDS OF DUVAL CO., FLA FOR 1 ~? OU.~T/~ CA~PDE.vS d4~.vT /fq/t[/.QE ' NOTE HE4RING DATUM SHOWN HEIIEON ARE 9ASE0 ON THE A OVF MEN TONED PLAT .vo>E SEE A77~CNEn LE6~1L ~~cpiPfiGW. ~' •~s. ~ ~` '~ is. ` ~ ~~~ cr„psEAY ~ e ~ 11 'VT ~~ p ` ` v ~~~~ 1 ~ ~a o`~,a'~ ~ 1 I • ~ ~~ ~ '~ a •, ~~ 0,.55 '' ~ i~ • ~' ~ y ~ '~ G del ' ~ ~+~~ y o ~ `~ 1 •~ ~ fD~~~ ~ ~3 • I l; 1I Y ..sir ~~~ ~ ~ 1' t;~~~ ,t ~+ v " ] ~ as z~ :Q wJ 1,.i {~ ~ ~ e 1 npi .mss 28 '' 4' ~ _ s,1''~ `~'~4 ?~~ 1 ~ ; ~1. ~ y- ~, ~•. ~.9 I o x 1 v ~ ~~~ v O ~ • ~ 1 a ~~ ~ - ~ t~~ 3 ~~ .----- o -.~ `~ ~ ~ 1,~ .--- ~ y •. ~ .o o • ~~_