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Permit 892 Ocean Boulevard CITY OF ATLANTIC BEACH a. 800 SEMINOLE ROAD -�} ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 it Application Number . . . . . 10-00000561 Date 5/13/10 Property Address . . . . . . 892 OCEAN BLVD Application type description RIGHT-OF-WAY PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc concrete to pavers ---------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- HARRIS, BOB OWNER 892 OCEAN BLVD. ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit DRIVEWAY PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 11/09/10 ---------------------------------------------------------------------------- Special Notes and Comments Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. A sewer cleanout must be installed at the property line. Cleanout must be covered with an RT1 concrete box with metal lid. Cleanout to be set to grade and visible. Roll off container company must be on City approved list and container cannot be placed on City right-of-way. Roll off container company must be on City approved list and container cannot be placed on City right-of-way. ---------------------------------------------------------------------------- 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. BP250U01CITY OF ATLANTIC BEACH 5/13/10 Application Tracking Step Selection by Revision 15: 15 : 24 Application number . . . . : 10 00000561 Address . . . . . . . . . . . 892 OCEAN BLVD RE number . . . . . . . . . . 170344-0000- - Application type . . . . . : RIGHT-OF-WAY PERMIT NCR OLD ACCOUNT NUMBERS . . : ABO1108 Tenant name, number . . . . . Type options, press Enter. 2=Change 4=Delete 5 View 6=Fast log 8=Action log maintenance 9=In/out maint Path ---- Rey Dates --- - Action Summary - Opt Agency description Rev Step Req In Est Cmpl Last Type By PUBLIC UTILITIES A 01 Y 05/11/10 05/26/10 05/11/10 AP LS PUBLIC WORKS A 01 Y 05/06/10 05/26/10 05/12/10 AP LS Bottom F3=Exit F5=Land inquiry F6=Add F7=Revisions F8 Misc info inquiry F9=Corrections report F10 View 3 Fll=Sort by agency F24More keys FIL E cop y, . ..i --: ,� �7 APPLICATION NUMBER .• City of Atlantic Beach �.f 1. '- A -� - (To be assigned by the Building Department.) Building Department 800 Seminole Road �'�` �'�() 40,_- Atlantic Beach, Florida 32233-5445 Phone (904)247-5826 • Fax(904)247, 8�5ry T__, pate routed: E-mail: building-dept@coab.us - City web-site: httpi//www.coab.us APPLICATION REVIEW AND TRACKING FORM P2- IFFire tment review required Yes NoProperty Address: g g &Zoning Applicant: T strator /9� L-51 7 1 J � Project: i / Utilities ervices Review fee $ Dept Signature Review or Receipt Date Other Agency Review or Permit Required of permit Verified B 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: BUILDING PLANNING &ZONING Reviewed by: Date; _ TREE ADMIN. Second Review: ❑Approved as revised. []Denied. PU Comments: GD �O Reviewed by: Date: PUBL C SA ETY FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: i Reviewed by: Date: Revised 05/14/09 Public Unties Plan Review Comments Initial Date: 5 �10 �1�� Application Permit#: 10 - 056/ Project blame/Address: :Check 33flx to:add Application Tracking COM'nant; Comment vertical and horizontal ❑ Avoid damage to underground vaater/sewer utilities. Vel' on is needed, call location of utilities. Hand dig if necessary. field coordinate necessary- 2247-5934. Sewer cleanouts and valve covers are set to grade and Ensure all meter boxes, visible. roe ,line. Cleanout must be covered A sewer cleanout must be installed at the p e rt5 with an RTI concrete box with metal lid. Cleanout to ustaIl d if irrigation visible. � reventer must be ❑ A reduced pressure zone baclI low P Backflow preventer must be provided or if there is a private well on the proper ent to Public Utilities tested by a certified tester and a c Y�ed plans change 111 y fire line installed plans note the building will be 11nSp properly sized vault and an ❑ must be metered with a Sensus touch-readB��o pre enter must be tested by a appropriate bacl'low prevg fie-results sent to Public Utilities. certified tester and a co ycontact lvlaleolm Clemons at 247- 839 for ❑ If fire sprin}�er system is provided, ow requirements. At a nvnimum,will require double check bacl low backfl q reventer. M touch-read meter. eters larger than 2" 71Fire lines must be metered with a Senses must be installed in a vault as noted in TEA s ecifications. 1 r �, CITY OF ATLANTIC BEACH M. 4�r CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS 904-247-5800 800 Seminole Road Fax 904-247-5845 >1� Atlantic Beach,Florida 32233-5445 PLEASE SUBMIT(3) COMPLETE SETS OF PLANS WITH APPLICATION. Date ®4� �PPERIVIIT# SUED BY THE CITY Job Address Qq2 1- /J `����� � �,-Zr �j✓ Telephone# Permitee: /'/ Permittee Address: Requesting Permission to Construct: Location: (Reference to Cross-Street) 1, Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. A Letter of Notification was mailed to the following Utilities/Municipalities: / (✓ Jacksonville Electric Authority Yes ( ) No Date:(� Date: Bell South Telephone Company Yes ( ) No Yes ( ) No (�j)' Date: Ferrell Gas Yes ( ) No (A Date: Comcast 2, Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation, alteration or relocation of all, or any portion of said street or easement as determined by the Director of Public Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately removed from said street or easement or reset or relocated hereon as required by the Director of Public Works, and at the expense of the Permittee unless reimbursement is authorized. s and be 3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Project performed under the supervision of ► , I Telephone#7 t3�1--4�� � 7 Superintendent) located at 4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee. 5. All city property shall be restored to its original condition as far as practical, in keeping with city specifications and the manner satisfactory to the city. of a recent survey shall be made a 6. A sketch of plans covering details of this installation, as well as, a copy Y part of this permit. Calculations showing any increase in impervious area on owner's lot or in the city Right of I�tfaV are to be included with this aaaggatton. 7. This permittee shall commence actual construction In good faith with _ days. If the beginning date is more than 60 days from date of permit approval, then permittee must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permifted construction. B. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all times, assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and all loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. 9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon completion. e; s JASON DP,ACI-i BigQad•;Af"' --! r ( �G� � ` rm$,�'a °_:�a: # DD_ F510 34 My COMMISSION OWNER 6EXPPES:August 9,2610-1 fWOV Bonded Thru Not , Before me this day cf k /®in the County of Duval, State of Florida,has personally appeared I- C: Notary Public at Large,Stat f Florida, CQ,�my Df Duval. My commission expires: �'"0f / ' B Q Personally Kn n: Produced Identification: of for R.O.W.Permit Attachment 200 Atlantic Beach,FL 32233 R.O.W. Permit# ,issued Owner's Name: Property Address: '3`�2 Tilk Subdivision: Lot#/Block Lo - 1 R.E. #: REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of 200_, by Atlantic Beach, Florida, a municipal corporation organized and existing rida,hereinafter referred to as "CITY" and under the laws of to State of Flo of Atlantic Beach,Florida,hereinafter referred to as"USER". WITNESSETH: escribed h That the CITY does hereby grant the USER permiseach for the a ein the the purpose described n the City siCity of right to enter upon the property of the City of Atlantic B Atlantic Beach Right-of-Way/Easement permit numbers noted above (copies attached). This work is generally described as: G te Any facility maintained, repaired, erected: and/or installed in the exercise of he rivi ed notice to days remains subject to relocation or removal on thirty (30) dy notice by CITY to theaddress: USER shall be given by certified mail, return receipt requested, to the following The deposituig of said notice of cancellation in the United informed maof USERil I proper adthe notice of cancellation and the burden is upon USER to keep the CITY The USER shall promptly make any and all necessary repairs to ant ifn said faility cected or ility Iity in good and safe ined in to exercise of the privilege herein granted and shall at all tunes m i condition. ve or other In the event it is necessary for o CITY or the City's TY the USER halloved rreplace at the USEWs utility to enter upon the above-described property 0f the CITY, essarily displaced during the action of maintaining, repairing, sole expense, any and all material nec operating,replacing, or adding to of the utilities and facilities of the ITY cr ftarclaise utili;�provider. f t1-1e City The facilities allowed by the penllit shall meet the current e and code aurrements uire rents of to CITY,Code, Building Codes, Land Development Code, and all other land use q City Code Section 19-7 (h) which states "Driveways tl at cross ne etesleftrr atural llallcolo asolthat i ot be replaced with other materials, but must be replaced wn smooth co matches the existing and adjoining sidewalks." Page 1 of 2 The USER, prior to making any changes from the approved plans and/or method, must obtain written approval from theCity of Atlantic Beach, Public Works Department, for said change. The USER shall, at the discretion of the CITY,be requested to submit as-built drawings showing the change within thirty (30) days after the day of completion.of, on, the USER and their respective This permit shall inure to the benefit of, and be binding successors and assigns. ble State CITY USER shall meet the terms and conditions of this permit mdnto aandof se limitations/requirements of laws and/or specifications, to include utilities locate requirements public rights-of-way and other public land. USER furtlier gee w rk herein underthe termsofficers this employees shall be saved harmless by the USER from any o permit and that all of said liabilities are hereby assumed by the USER. DTEI�and IGNED this day of Prope Owner (to be signed in presence of the Notary) STATE OF FLORIDA COUNTY OF�AL On this f day of #9 2040, personally appeared before me, a Notary �it�- �= f'T`'«'"F'f the property owner of Public in and for said Co un and State, Atlantic Beach, Florida, known to me to be the person(s) described in and who executed the foregoing instrument; who acknowledged knlowle�gendn mentioned. edthat he or she executed the same freely and voluntarily and for the use purposes JASON DRACH Y P! 1PR,..Ug�i•. MY COMMISSION#DD 583034 �.. ;o EXPIRES:August 9,2010 Not 'c un for sai County and State ';F o, Bonded Thru Notary Puhlic Underwriters CITY OF ATLANTIC BEACH,FLORIDA, a municipal corporation: Approved: Ricky L. Carper,Public Works Director For Permits where city sidewalk is impacted, City Manager approval required: Tim Hanson, City Manager Page 2 of 2 K'01SHOWING SUS sr ' V OF AS RECORDED IN PLAT BOOK- � R AGES. ..._: ...__... Of THE CURRENT' PUBLIC RECORpS C COUNTY, FLORIDA. FOA AG-504 ?40 Dc, esp. 000 IN lie•x ,. ►. •' ,•. per. lye. �/�•d��• _ {p►�9.���.s' -� ZOr /3 i �. CY"yioU5 !SUYl LCA? 1��t�U1 As 2 n All Lot a�y-a?, ' S( 2 ko()so, 2 , It SF -7g8 S� 25� e4 130 2-0 t D City of Atlantic Beach - I APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247Date routed: Ji3 �3 E-mail: building-dept@coab.us ----- City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 9Z cf�-n r0 :ilding partment review required Yes No Applicant: nning &Zoning T ee trator Project: ,� �r�r �. �� IS bli ublic Utilities 7ubervices Review fee;$ Dept Signature Review or Receipt Date Other Agency Review or Permit Required of Permit Verified B 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: BUILDING PLANNING &ZONING Reviewed by: Date ' d TREE ADMIN. Second Review: ElApproved as revised. ❑Denied. 4PUBL Comments: l Date: ETY Reviewed by: FIRE SERVICES Third Review: QApproved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 Public Utilities Plan Review Comments Initial Date: 8�a- ���� Application Permit#: 10 - 0561 Project Name/Address: ©CeG r :Check Boa to Add Application Tracking Comments :Comment t ihorzonal and Avoid damage to underground water/sewer utilities. Verify vertical ❑ location of utilities. Hand dig if necessary. If field coordination is needed, call 247-5934. Ensure all meter bogies,sewer cleanouts and valve covers are set to grade and visible. line. Cleanout must be covered A sewer cleanout must be 'nstalled at the property with an RTl concrete boa with metal lid. Cleanout to bes 1 a if n willlbe A reduced pressure zone backflow preventer must e Backflow preventer must be ❑ provided or if there is a private well on thte property.sent to Public Utilities. tested by a certified tester and a co y ed. If plans change, any fire line installed Plans note the building will be unsprjnkl must be metered with.a Sensus touch-read meter in a properly sized vault and an ❑ appropriate bacic low preventer install ed. Bacl�low Preventer must be tested by a certified tester and a co y of the results sent to Public Utilities. If fire sprinkler system is provided, contact Malcolm Clemons at 247- 839 for ❑ backaow requirements. Ata minimum,w� require double check bac] low reverter. Qer than 2" ❑ Fire lines must be metered with a Senses touch-read meter. Meters Lara must be installed in a vault as noted in JEA specifications. ❑ ri ❑ CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 J INSPECTION PHONE LINE 247-5826 .W 10-00000022 Date 1/08/10 Application Number • • . . 992 OCEAN BLVD Property Address . . . Application type description ROOF PERMIT Property Zoning . . . . TO BE UPDATED Application valuation . . . . 5000 ---------------------------------- Application desc FL6623 ----------------------------------- Owner Contractor - ------------------------ ----------------------- SANYOUR, FRANK D. CB ROOFING 992 OCEAN BLVD. P O BOX 50935 ATLANTIC BEACH FL 32233 JAX BEACH FL 32240 - -------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . Plan Check Fee . 00 Permit Fee 75 . 00 . Issue Date . . . Valuation 5000 Expiration Date . . 7/07/10 ---------------------------------------------------- Fee summary Charged Paid Credited ---Due --- ----------------- ------ ---------- - ------- ---------- Permit Fee Total 75 . 00 75 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 75 . 00 75 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. .S trlf`p 1'ri r s) 09-- oil 9- oil �r CITY OF ATLANTIC BEACH ROOFING PERMIT APPLICATION Date: Job Address: 44 o CE ✓0 r c -rs G Owner of Property: t71Art A Vito ss-f< VP _Telephone: Address: CCC /3 a 7/.3 Cdac r1 ego w r/ State License Number: Roof Contractor: FL 06-c) 5,35 9A-Y, 6 r Arc (4 3 a a.5o Contractor's Address: d t/ �7 Telephone: D D) J D36i Fax: !)7q 3Email: 14 yo2o s�oP y p 9-0 O P IC c A-I- k0p F Roofing Material Scope of Work: V G G 4.23 Valuation of Work: FL Product Approval# Required Inspections: Sheathing/In Progress-Dry If re-roof: Assessed Value of Structure:,_<$300,000/_->$300,000;Roof-to-wall improvements required? (Applies to single family structures only) F COMMENCEMENT MAY RESULT IN YOUR PAYING "WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE COMMENCEMENT MUST BE RECORDED AND POSTED IN C TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND To FINANCING, CONSULT WITH YOUR COMMENCEMENT* LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF Date: SIGNATURE OF OWNER: AS TO OWNER: da of •20 Sworn to and subscribed before me this y State of Florida,County of Duval Notary's Signature: 0 Personally known 0 Produced identification Type of identification produced Date: / $70�v SIGNATURE OF CONTRACTOR: SUSAN SPEAKS GORMAN AS TO CONTRACTOR: 3--,q N LkA 2 20 MY COMMISSION#DD643668 day of EXPIRES:February25,2011 Sworn to and subscribed before me this�— gw;.NOTARY Fl.Notary DiscountAssoc.Co. State of Florida,County of Duval Notary's Signature: ' 0 Personally known rLoe I ) 4 PProducedidentification / 5� .� �� O�0 -C Type of identification produced I� (i� .L 800 Seminole Road-Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800-Fax:(904)247-5845 F:\roof permit applicaton.docx 7/28/09