Permits 725 Atlantic BLVD # 5 FERRELLGAS 2011 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 11-00001569 Date 1/31/11
Property Address . . . . . . 725 ATLANTIC BLVD UNIT 05
Application type description RIGHT-OF-WAY PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
REMOVE GAS TANK
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Owner Contractor
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NORTH BEACH CENTER FERRELLGAS L. P.
725 ATLANTIC BLVD UNITS 1-21 922 9TH STREET SOUTH
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 246-7316
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Permit . . . . . . MECHANICAL GAS PIPE PERMIT
Additional desc . .
Permit Fee . . . . . 00 Plan check Fee . 00
Issue Date . . . . 1/31/11 Valuation . . . . 0
Expiration Date . . 7/30/11
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Special Notes and Comments
Avoid damage to underground water/sewer utilities . Verify
vertical and horizontal location of utilities . Hand dig if
necessary. If field coordination is needed, call 247-5834 .
Protect sidewalk and curb and gutter. Resore right-of-way
with sod.
Notify Public Works (Mark Lyon - 838-8076) prior to
beginning excavation.
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total . 00 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total . 00 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach
APPLICATION NUMBER
A A(I
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-54 5 JA/V
to)
Phone(904)247-5826 - Fax(9 JA�7-�5845
r E-mail: building-dept@coab.us Date routed:
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
S- A-7 A
Property Address: lvd Department review required Yes No
Building
Applicant: Arall - Planning &Zoning
Tree Administrator
'Publ'
Project:
Fire Services
6 't'S.'
4
8w, iw, e
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
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: aApproved.
(Circle one.) Comments: 0, .- /L�
Z_r
BUILDING
PLANNING &ZONING Reviewed by: Date:—)
TREE ADMIN. Second Review: E]Approved as revised. ElDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [:]Approved as revised. DDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
800 Seminole Road 904-247-5800
Atlantic Beach, Florida 32233-5445 Fax 904-247-5845
Date to / If PERMIT#
Job Address ISSUED BY THE CITY
Permitee: Telephone# Cf C 3 5' V 0
Permittee Address: 94RI.1) 2,.1 y
Requesting Permission to Construct: 4t4et)h
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 (Y) Date:
Bell South Telephone Company Yes No (',Y) Date:
Ferrell Gas Yes No ( ) Date:
Comcast Yes No (Y) Date:
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.
3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be
performed under the supervision of J 41 111" J171 tc_ (Contractor's Project
Superintendent) located at 5 CJ 1'�j -i-,4 V ,32-A o 9f Telephone#: "j"
I _ , 71-
4. All materials and equipment shall be subject to insl5ection by the Dirktor 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.
6. A sketch of plans covering details of this installation, as well as, a copy of a recent survey shall be made a
part of this permit. Calculations showing any increase in impervious area on owner's lot or in the city
Right of Way are to be included with this application
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 permitted construction.
8. 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.
OWNER
Signed: Date:
Before me this day of in the County of Duval,
State Of Florida,has personally appeared
Notary Public at Large,State of Florida,County of Duval.
My commission expires:
Personally Known: or
Produced Identification: