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Permit 15 Forrestal Cir paver patio 2011 s CITY OF ATLANTIC BEACH s 800 SEMINOLE ROAD =+ ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 11-00001609 Date 2/03/11 Property Address . . . . . . 15 FORRESTAL CIR Application type description RIGHT-OF-WAY PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 -------------------------------------------------------------------- Application desc paver patio --------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- PARKER, RICHARD & IDA OWNER 15 FORRESTAL CIRCLE ATLANTIC BEACH FL 32233 -------------------------------------------------------------------------- Permit . . . . . . DRIVEWAY PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/02/11 ----------------------------------------------------------------------- Special Notes and Comments Ensure all meter boxes, sewer cleanouts and valve covers are 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. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35 . 00 35 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 39 . 00 39 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. j Ord � -o f-r6gr,4-C AN 14- ,5,�V - BOUNDARY SURVEY of LOT 19 BLOCK IATLANTIC 13EACH VILLA UNIT NO. 1 .. AS RECORDED IN PLAT/DEED BOOK 30 PAGE(S) °.55 OF THE CURRENT PUSUC RECORDS OF DUVAL COUNTY, FLORIDA - _ PROFESSIONAL SUI 17758 1 - oaaa LAND PLANNERS 9 6 903 1125 0 E 7 5.0101 ' - 3238 SUNBEAM ROAD, SUPrE 2 X LOT 213 s' LOT 1 9 LOT 18 (904) 886-9388/1 B L❑C K 1 'I BFREBY CERTIFY. That this - furTe7 made under my repo LSa Iatest IEWmum Technical X promulgated by the Florida S - and Yappars, Chapter 01G17, Pursuant to Section 472.027, Q - _ Q - .. note* and aotatlonf shown h, ❑ ❑ 02-137PO7 • 0 DAT3 FIELD Ir . ❑ A/0 - ❑ El • ' 16.1]' N; I11- 18.H 43.40 - THURRM B. M,G FI,( L� (010.00' !n Suri efcr Andlthcrelarst Lho ur . _N regar'�r�. latormstlon shown e m CAR _ - _ _ eaaemcrib,•dnlms of euemea - - N- E 1 HTp]RY FRAME p Q - otertapi, bounds.-T line dlrpul O N reftrtetlse cpcensnts. ewnerihi . ❑. 7 RLH # I S P O facts that An accurate and cu N N N ❑ I THIS X SURVEY IS A E D ITE AN N /J N OF 7X8 CllE:iT N1YID FIEREON . Z POST 33.20' 16.0' IJ) - AN ORICLN"SICNiTURE A.NU A: . T _ „ t PREPARED A!`,D CERT7129 FOR•. 30.0'B.R.L. t T e.e❑ 30.0'B.R.L. RACHEAL r lq N CI 1 �O C4 1 - CE{T.I'n TO: _ FIRST N • ; ';'- • STEWART 13UAF T x 20!$.l I' P C. E?TEYJART TITLE J. o a' N b9°31125" W 75.00' PROD. No.: 07.050 FORRIEaTAL CER. NORTH ( 60 R/W ) SCALE: 1:20 D.RAHN BY: 6.N. . SEC. VIP. F.I.R.M. FLOOD ZONE: NOTE: BEAr.INQ9 HASED FROM THE NORTH RAVCOz1MU1ITy PA,.'EL No.: LINE OF FORRESTAL CIR. NORTH N.69*3112!5'W. DATE OF F.I.R.M. INDEX: �rar;unoxs 1tlRTa:ATA: Suin-ET ANNOTATIONS— fe -NR CONpDONOt i'Jt -FARC HIDRANT P0. -FACE L -DELTA O --F140.oZe.UGHUNENT (NO L0.) -NO IDENTIFl[ADCH Ott -ASPHALT ►ND. -FLVHD PX. -PAR(m KACN HAIL D -DECREE OF CRYE 0 -SET CCNQ WOHUUENi --X—k---CHAR LW FQKC pp u. _5CNCH UNIX CM -CARACE P.O.0. -POINT a CEWORNO R -RADNS •. -:H0.ft01/P'Pf DD -+—+---WFZC MOE NO. 1.EVISIOI 0.L BtD•:.R671SCTION UNE C.K -CUY MRE P.0.0 -P„)W OF CDUIIRFGEUENT L -LENGTH OF MG O -SET Waxi F'tPf'J4tR00 --p__p_ _>tpOD Fp.,rC :1 -CALC AATm M.W. -MEAD WALL I-) _P NAL UNE C -LLN.TH OF CHORD -PND.DP.4L HOLE CROSS --CV--V--O%MEAD CABlEMSICH & -CENTER LINE L0. -LICENSE&)SHESS ILLS -RECSTCRCD RANO SIRVEYCR CS -CHO'D BEx"O -SET DiCU.1•KLE�R95S --E—E-- _O%zRH AD ELECTRIC PML -FIELD MEASURED R/if -R:CNT-CF-*'AY T -LENG711 OF TANCE tT -FN0.P.K NAL __T__T OLEFtHCAO TEL£PHt(E SERV. r. -co PORa UA -VAt+RaE s,v -sAMTAaY Pc Pc.�r G aR+ATURE -SET Px FNL ¢ -PorER POLE(n000X ) R. -CXIHTY ROAD MOH. -MO`RUUENT S.F. -SA'REENED PO" Ft -POINT of IHTUMCr,,t Q -FND.NMC;ASX (METALXnDot0.JE53) j -:DCFD ORK -CMOAL RELURO WIS/uE T.LM. -TEUPOa.ARY aCN04 YARN PT -POINT CF TANGENCY Q -SET NAL/aS1C •l .:DC4CH$LWM£VAT17H 9. -F* TRANS. �•TPAtiSSOwER PCG -PONT DF Cl1u=HD LURVANRE A -END.TRA,1RSE POINT � C:'r' -BETE !. _-Fl•^-0 SOON P.C. -PSL CONTROL PONT TRI. -R,Tv PRO -PONT Of R.\ETSE CRClATURE A. -SET TRA—SE PGM. jz=z -ASPHALT - -FNSH FLOOR ELEVATION PAP. -PORAL F4)rE1?DXC PONT W.M. -LVAT[A lETER PUT -PCL%r OF NCA-TANCENCY 8 -FAC.R/a'cc#F .MONJWENT Page 1 of 1 OF * 1794611 * Print Date: 1/31/20112:57:11 PM Transaction 4: 1794611 Receipt 4: 1735061 Cashier Date: 1/31/2011 Jim Fuller 2:57.07 PM Clerk Circuit Court (SSULLIVAN) Duval County 330 E. Bay Street Rm 103 Jacksonville, FL 32202 (904) 630-2044 Customer Information Transaction Information Payment Summary DateReceived: 01/31/2011 Source Code: BEACH Q CITY OF ATLANTIC BEACH Q Code: BEACH Return Code: Over the Total Fees $20.00 Counter Total Payments $20.00 Trans Type: Recording Agent Ref Num: 1 Payments p � CASH Tendered: $100.00 Refund: $80.00 $20.00 2 Recorded Items BKPG: 15500/2148 CFN.•2011024157 R (N/C)NOTICE COMMENCEMENT Date:1/31/2011 2:57:04 PM From:ATLANTIC BEACH CITY OF To: COMMENCEMENT INDEXING 2 $0.00 RECORDING 1 $10.00 BKPG: 15500/2149 CFN.2011024158 R (N/C)NOTICE COMMENCEMENT Date:1131120112:57.04 PM From:ATLANTIC BEACH CITY OF To: COMMENCEMENT INDEXING 2 $0.00 RECORDING 1 $10.00 0 Search Items 0 Miscellaneous Items file:HC:\Program Files\RecordingModule\default.htm 1/31/2011 BOUNDARY SURVEY of T LOT 1 9 BLOCK 1 ATLANTIC BEACH VILLA UNIT NO. 1 .. AS RECORDED MPLAT/DEED BOOK 30 PAGE(S) SEs` OF THE CURRENT PUBUC RECORDS OF DUVAL COUNT; FLORIDA - PROFESSIONAL S1 1 77581 - 0000 LAND PLANNERS 1.8' S 69°3125 E 75.001 9998 SUNS£A]i ROAD, SHITS LOT 2O B' LOT 1 9. °'' LOT 1 B (904) 886-9986 B L a c K r-f, WGc�c( _ "( HEREBY CERTIFY,That U ■urTcy made under'my res x Lhe latest UL!mum Teehnl promultatcd by Us Florlds Z Mappers. Chapt*r 8161 . PuTscTant to Sect!oa i72.0� (3 - C) .. notes and aotitlon■ shown ❑ ❑ 02-07-07 ❑ ❑ DAT3 rEM if �TEl 13113 13 A/0 IL ' x 3 THURVAN B. KING F1 I 13.8 43.40 16.0 . 1.7 �" IOIO.QO' IIl NOTATION. This su".r does . ❑ �` Sunrycr and thcrafar's Lbo fl _❑ Teta !.;term soca ahoti r11 CAR eueacn(r cWma of easem O 1 6TFDHY FRAME C Cq - - oTerlayi, bounds.-r line dlsp O E N - reatrL O COTcaants. OTTner. `f R88# 1 is O _ tech that as aecw-a Ce and . 13 N N H - 3 0 THIS SURYLY Ls PREPARLD A; / N OF TKI CHENT WAXED rrERE1 z PART 33.x0' t fi.0' Ij] AN 0P1GL;AL SICNATtTRE AND PREPARED AND CtRTU1ZD FO', 6.501 � t � 3D.fl' O.R.L. r 30.0 R.L. / . RAO HE, t0.2' 0 - CERTIFIED TO: 9TEWART C3U/ 1203.1 1ETEIYART TITLE N 69°31125 W 75.0.01 FROJ. No.- 07.050 FOR RBSTAL CUR. NI3PTH ( 60 RIW ) SCAL: 1:20 DRA" BY: B.N. ' SEC. Tiff NOTE: F.I.R.M. FLOOD ZONE: SEARING3 SA9E0 FROM THE NORTH R/VY COMMUNITY PANEL Aro.: LINE OF FORREBTAL CIR. NORTH N.69e31'2!5%V. DATE OF F.I.R.M. INDEX: ASDar,unoxs CUM TATA: Stlsr-CY ANNOTATIONS: BASE FLOOD Elu�•Y.07ON: ♦/C -NR LONODONER F'3L -FYK iiTDRAHT PC. -P.ACE --DELTA E3 -TWO.CG+G MOHUMLNT (NO LD.) -NO 1DEXTWXAMCH 1 &3?K -ASIULT NO. -ram - PX. -PAWZR KALOH RAIL D _XCREE CF CURVE ■ -SET C/JC WONWEIT --t—k—-CHAN UNC MCC Ea. -B''40"MARK CAR. -GARAGE P.A0. -PUNT a LLC+NNM R -R"13 1. -rm no"Pnp/Roo -+—+--_WRE MCC NO. REVISI( tAL -mm m3mCRCH twe Gk -WY TARE P.O-C -P'.+MT Or C`UMDJCEMENT L -LINM OF ARC O -SET IRON PWE/R00 —D--D- -TgCO F4J<E t:) -CALCULATED Kv. -HEAD WALL. (RL) -Rti'1AL LME C -LENGTH Cr CHORD } -FN0.DPoLL HOL</CR053 --CY-•-CY--O YWCAD CABLM9CN r"L -CENTER t•N _ L IL -LTCOISE BUSNESS 1% -nc;sTERfZ LAW SJR�trcn C9 -04aV ECA/L'xC -}• -SET O.ZLi HCtE/CRUSS --E--C-- -C%VtNC40 ELECTRIC PML 03+G -CCNCRETC (M) -FIELD MEASURED R/N -tm-HT-CF'-WAY T -LAOTH OF T/VC,NT -FH0.PX HAL --T--T— -VWRHEAD TELEPNO+E SERV. CF. -C`011."LD PORCH MN. -NA'L4CLE SAN. -SAFIIiaRY PC -•PMT OF CUl.YATUP.E -SET PJC.WJL PCMB POLE(W=XCCNC.) U. -COUNTY ROAD MON. -MCtM,ENT SP. -SCREtNED PC" PI -PONT OF WTCRSECr.'Yi Q -ENO.NNLL'GSit (1tE'iALxFR3FR0.A55) Dl -'OED OAK -OFF1Wt.RECORD VOLumC T-B-Y. -TCupCRART&0"MAK Pr -PCaT CF TANGENCY [J -SET NAL)ASK $• ._BENCH MARUC+ELEYA77W 9. -P.AT Tf"S -TRAi:sro!t CR PCC -PORT OF CC;WCUHO CURVATURE 4 -IT+D.TFW_RSE PGMT A. -CONCRETE r2. -fi^-.DD•eCCK YAGP. -PER.UL CONTROL PONT A0. -Tr:XA7 PRC -PUNT CF R K1i5E 0.7LYAnJRE ♦ -SET TRAV,T.SE PUNT- mta'a -AWMT `, •-r"SH rLOOR ELEYATPM P.RP. -PERM•REFERENCE PONT TUL -TTaTER LETER PNT -POhT OF HG1-TA.HCEKCY .3 -ENO.RIs COF✓C YOSAKNT Q 4 UST �w BAS FCP y s al�il 15 N FORRESTAL CIR Atlantic Beach FL 32233 Building Type 0101 - SFR 1 STORY SOH Year Built 1960 Type Gross Area Heated Area Base Area 957 957 Unfinished Storage 80 0 Finished Carport 200 0 Unfin Open Porch 60 0 Total 1297 957 BOUNDARY SURVEY � ACCURATE of T 19 BLOCK IATLANTIC BEACH VILLA UNIT N0. 1 TOPOLOGY EO BOOK 30 PAGE(S) 56 OF THE CURRENT PUSUC RECORDS OF DUVAL COV.4M FLORIDA - INC . �. 177581 - anon PROFESSIONAL SURVEYORS Sc MAPPERS. 9 69°31125" E 75.0101 0.�• LAND PLANNERS 3236 SUNSEAYROAD, SUrrE 2. IACESONVII2-E.rL32257 :31B' LOT 1 c-9, �'' LOT 1$ (904) 860-9386 /TAX 686-Da67 B-Lo--C K , -I HEREBY CERTIFY. That this map doplcts the results of a f1d13• - - - surrey mads under'Te relc.l Stsn dirs for and eomptlea rlth L`ie leis:!Yin!muTs Ttchntc al Standzsds for SurrcJs'.u X promulgated by the Ftor(da State Board of Professional Surreyors ►nd Slappars, Chapter 61617. Florida AdministraL'ra Cade: Pursuant to Section 472.027, Florida Statutes: Subject L* all - -� Q _ _ _ notes and notitloos shorn hereon. 0 02-07-07 02-06-0 ❑' ❑ DATE FSElD XO ISfSD DATE UAP SIGNED 13 0 cl ILi 15.13' 7 6.0' x 3 THURifAN R. KING FL CERTIFICATION No 4,24 13 i.►3.sa I•� 211 O.D0'- If1 NOT)MON. This surroy does not COD.Utnta A utle'search I+y . I•(I Eq - Sureeycr and therefore the unders!gnad wakes no eexLftcatloa CAR rear...".�..nn�g tafcrro-W&n shown or not shown hereon ppeert.tniag to [j] - .. sauaents•ti.ims of euements,rights-of-xq,setback lines, - p 1 HTT]r`iY FRAME 13 --y orerlapi, boundalint dlaputes, 'agreements, reaerratfons. i•.t O E N _ _ - reetri.UYe eascoauts, eraenhip title eddeiee, or 1-v other t \\V L.R. It RCt3# i 3 Di O - facts that an accurate and current Utle search s..y disclose. N 11 —L N THIS CY 1S PREPARED AND CERTIFIED FOR THE EYCLTISIi'E USE N a _ OF 7Tffi CLIUE."R NUEED IIERPON AND 13 NOT Vh•IESS T[BEARS Z PORT 33.50' 16.2' (n AN OPIGE:1.SIGNATVRE ma AN rVZOSSED SURVEYORS SEAL PREPARED JIM CERTrMD TOR:. . - e.a❑ .: t�• ..r. 30.0' R.L. - / } T- RACHEAL MATED C9 N i cV :E rl .r CI CERT•1•tED T0: - e. "4 FIRST MAGNU9 l' . STEWART GUARNTY COMPANY x ° 405.11' p C, STEWART TITLE JACKS 0NVILLE, INC. N 69°31125" W 75.[]01 PROJ. No.: 07.030 SHEET 1 OF =t7 R R E 3TAL G I R. ht C1 PTH ( 6 C1 R/W ) SCALE: 1:20 F.9./FG(3): s4/30 DRANy BY. H.N. CBECKED BY: T.B.K. SEC. VTP. RNG. P SL NOTE: TS F.LR.B. FLOOD ZONE: eX' 55ARINt39 BASED FROM THE NORTH R!W CCNU 17TY PANEL,No.: 1 22075-0001 O � LINE OF FORRESTAL CIR. NORTH N.69o3-1'2e5"W. DATE OF F.LR.M. INDEX: 04-17-59 Pc CUR98:ATA SMLY ANNOTATIONS: BASE FLOOD ELEVATION: NIA -PACE y -CEL;A 0 •-FMD.00NC Y0rt1NCNT (tR0!0.1 -NO MTWXATICH � PX. -PARGR KALOH NAIL D ^DEGREE OF CURK ■ -SET CCA:C•WOMWERT --%-----CHArt"FD= PAIL -PANT o<tYGNN14 " -RAnvs - s. -MEL Feat►+PE/R - --.—*—-TARE FENCE No. P.-VISION � DATE . P.O.r -MINT Of C04UDxEI+ENT l -LINGM Of AAC O -SET PROM p1PF/iR00 —D--o- -MOOD FENOE LIN (RL) -RA:YAL UNE C - ^+M OF CNORO -M0.DP.EL HOLT*/CROSS CI---CY--OKRHEAD CABLVA904 - R.L.S. -RECSTERlD LAM SUR\ETLA cs -CNJiO ECA'ENC $ -SET A'ctl t3,E/CRO55 -_E--C-- -OVVNEADCLECTAC PwR R/'M -r•r,NT-CF-MAY T -LFTG;N Cr"SAtICENT -MD.PA NAL --T--T•— -"ItHEAD TELEPHONE Sum. PC-St4+Tx4Y PC -Pwr CF CURVATURE -SET PJC RAA. ¢ POSER POte(%=XCU+C) S►. -SOREENE0 PC" PI PONT- OF INTERSEC CH Q -FND.NAXL-*�SX (gALX=gl11 1 - L&Y. -TEUPCRAAY 00"1RARK PT -PUNT OF 7MCEN'Y 8 -SET NALMK •�•_. -etNot wVbR+t1EYAT�I - TRMS. -TPA'1SFcFYER PCC -PONT Of CSLAPOUND CURYATJAC Q -M0.TRAN'RS£P LA N T -CWCRETE . M0. -r.xv PRC -PONT CF R.KT.SE CURVATLRE A -SET TRA%V' SM PGHT- Cai'7 -ASPHALT NIL -1.141"METER PNT -PUNT OF NCH-TAYCENCY 9 -MD.R/r a*4A_WN.VITR City of Atlantic Beach + APPLICATION NUMBER Building Department ��+'1 Y >� (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 JAN 8 490 /J CPQ Phone(904)247-5826 • Fax(904) 845 oft E-mail: building-dept@coab.us Date routed: / City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: >/ �, ,G✓f 5 C !U Department review required Yes No Buil _.....__. Applicant: d��1-112 �8sZ>a Tree Ad.mi.Bistrator Project: -h It I✓f2 S Public W rks Pukl' Util ' Public Safety Fire Services Review fee $ r PPt !o6ture> r' �— 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: Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: l TREE ADMIN. Second Review: QApproved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: []Approved as revised. ❑Denied. Comments: l Reviewed by: Date: Revised 05/14/09 5% 'V f City of Atlantic Beach APPLICATION NUMBER ji _ J� iz Building Department (To be assigned by the Building Department.) 800 Seminole Road � �" �/ Atlantic Beach, Florida 32233-544 )d,�� Phone(904)247-5826 • Fax(904 247-58�q� / 6111 E-mail: building-dept@coab.us 201 Date routed: O City web-site: http://www.coab.0 BY: APPLICATION REVIEW AND11AACKING FORM Property Address: !"4e 5% C 1V Department review required Yes No Buil Applicant: d iV.77 Za g Tree Adtni.tlistrator Project: 77 cC�Vf/e 5 Public W .lSs Public Util Public Safety Fire Services Other Agency Review or Permit Required Review or Receipt Date 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. P WOI Comments: IC UTILITIES PUBL SAFETY Reviewed by: Date: FIRE SERVICES Third Review: 7Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 RECEIVED City of Atlantic Beach APPLICATION NUMBER Building Department .SAN 7 (To be assigned by the Building Department.) r t 800 Seminole Road /, j Z' Atlantic Beach, Florida 32233-5445 BY: 1 Phone(904)247-5826 • Fax(904)2 - "�� E-mail: building-dept@coab.us Date routed: a�t City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: �4r���1�L t- v Department review required Yes No p Y ild Applicant: ��) �} Planning &Zonin Tree Administrator Project: 1/ r T Publiork 11 LT .bJic...Utilities Public Safety Fire Services Reviewfee$ :.. Dept 519naturetl s _ _ ._ Other Agency Review or Permit Required Review or Receipt Date 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 /�4/-X PLANNING &ZONING Reviewed by: Date�-' ) TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 City of Atlantic Beach APPLICATION NUMBER >> ft Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 / C� Phone(904)247-5826 • Fax(904)247-5845 �b,6 9.1E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: T D �fS�Q (i/ /V Department review required Yes No Buil ' ___._______ _ Applicant: ;�2 Ian ing._&.Zona Tree AdmiB.istrator Project: -1 C a Vice 5 Public Wo Publ Util' Public Safety Fire Services Other Agency Review or Permit Required Review or Receipt Date 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: Y, BUILDING rLANNING &ZONIN Reviewed by: "' Date: TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax(904) 247-5845 Job Address: 6—i r Io /"d C,r . //,/�Q��qM-,c ����► /`L.3,�WPermit Number: Legal Description Parcel# Floor Area o q.l�t. q. t Valuation of Work$ /'� 0 . Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition poollspa window/door Use of existing/proposed structures) (cirinstalled? one): Commercial Residential if an existing structure,is a fire sprinkler system (Circle one): Yes No N/A Florida Product Approval# For multiple products use product approval form / Describe in detail the type of work to be performed: Property Owner Information: game: r � clel . - - r' Address: %S city State l Zip+� Phone 90�/ - y&7- k3f E-Mail or Fax#(Optional)-4 d1-, 4 Contractor Information: 3ompany Name: .�t'�-�- Qualifying Agent: 4ddress: City State Zip Dffice Phone Job Site/Contact Number Fax# State Certification/Registration# krchitect Name&Phone# Engineer's Name&Phone# lee Simple Title Holder Name and Address 3onding Company Name and Address Mortgage Lender Name and Address 1pplication 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 ssuance 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 end void if work as not commenced within six(6)months, or if construction ar work is suspended or abandoned fora enod of sax 6)months at any time after vork is commencecL I understand that sepcn ate permits must be secured for Electrical Work,Plumbing,Signs, Tells,Pools, urnaces,Boilers,Heaters, hanks and Air Conditioners,etG WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMAIENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR rMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COM IENCEMENT. hereby certify that I have read and examined this a lication and know the same to be true and correct. All provisions of laws and ordinances governing this vpe o work will be complied with whether specs ed herein or not. The granting of a permit does not presume to gave authority to violate or cancel the rovisions of any other feder state or I al law •egul ting construction or the performance of construction. signature of 0w>�Ji Signature of Contractor Tint Name / .�. - ........_ .. ......................... Print Name 'worn to and subscribe fe % "` Sworn to and subscribed before me its I�a7c4 A- AM. -a fthis Day of . 20 IRES'. U 01 . ra Totary Public "' o, "° Notary Public Revised 01.26.10 ��. '6. 7eel- S-5S 3/ d CITY OF ATLANTIC BEACH OWNER / BUILDER AFFIDAVIT I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE—OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES, R. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. ill, IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT. V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER—BUILDER PERMIT. ADDRESS j— HO NUMBER P NA '1,:1 / l SIGNATURE DAT Before me this day of ' 20// in the county of Duval,State of Florida,has Pe Ily appeared herin by himself/herself and affirms that all statements and declaratior"re true and accurate. Notary Public at Large,State of-- County of 13 P rsonally Known T"i/ //2f Z/,^7 duced Identification- / S' / C__ V v l T S 1 DEBORAH A.WHITE MY COMMISSION#DD 634126 ! ( /� —' ,..� `a- EXPIRES:May 21,20 nden d1ar Notary Signs - -1. oa• Bonded lhruNMary tJndew FBLDG/Owner,BuilderAffadavii;REVISED; 4/16/2009 1 � 1 c be - BOUNDARY SURVEY A ACCURA'T'E . of T TOPOLOGY IT 19 BLOCK 7ATLANTIC BEACH VILLA UNIT NO. 1 DEED BOOK 30 PAGE(S) :Sd OF THE CURRENT PUBUC RECORDS OF OUVAL COUNTY, FLORIDA INC.e r 1 77591 - (7003 PROFESSIONAL SURVEYORS & MAPPERS, s' LAND PLANNERS S 630 901'25" E 75,0oz• 1 3238 SUNBEAM ROAD, SUITS 2, TACESONVAI%,rL3226T T e' LOT 19. �'' LOT 1 8 (204)836-2386/FAX 68d-2367 BLOCK I 'I HEREBY CERTIFY,That this map depicts the results of-A field the IA xt U under my responsible direction and comaUn with ' the latest Mln!mva Techalcal Standards for Surveys; as "----tl-•�_ X promulgated b the Florida State Board of Prcfessioaal Surveyors and Mappers, �pter 61G17, Florida Administrative Code: r Pursuant to SecL'on 472.027, Florida Statutes; SuD)ect to sL - .01 Q _ _ - Q .. not" and notations shown hereon.' 0 0 02-07-07A172-08'07 ❑ (] DAT3 FIELD XO LfifED . -y DATE MAP SIGh•ED El 0 IIJ 13.x' O O 43.1❑ 16.0 i 3 THURYAN B. KEG FL,CERTIFICATION No 4424 z N t.0 3 X— 0 1010.00' - Ul NOTATION.This survey dose not eensUtuto A Utie*search by •- F--••� Efl� S�rrrcror and therefan the underv!g0ed makes no eertlleatioa \f CAR - reg�rs.1n�1pterm atiea shown or not shown hereon ppeertataing to C IQ m easements, claims of easements, rights-of-way,aetlack lines, N 1 BTf]rZY FRAISE overlaps, bounda.-1 Ila* dispute agree mems.reservations. O E (V restrictire covenants, evner3hip title evidence, or any other 13. Y R£9# 1 6 _ O _ facts that an accurate and current Ulle scareh_resy dietlese. N ro %.•.�- / N 77i1S S13 URVEY IS PREPARED AND CERTIFIED FOR TRE EXCWSVf%USE Z OF THS CI3E. NAMED BEREON AND 1S NOT VALID UNLESS IT BEARS . OR 33.20' 1-d.CI, ((I AN OF.ICL'V•AL SIGNATURE A.'.-D AN EHAOSSED SURV%YORS SEAL 't FIMPARED A" CERT720 rORr. 3D.0'B.R.L..`. RACHEAL MATEo ti rE7 p to CERTIFTfiD T0; E TI aw:r Ph . a STEWART O ARNTY COMPANY •l. X »4.•. 1pd.11 P.C. 13TEWARTTITLE JACKSONVILLE, INO. , 0-2 N 69031125" W 75.00' PRO7. No.: 07.0'3t3 Sh'EET 1 OF 1 �� Fb R P E STAL C{R. N O RTH ( 6© R/W ) SCAM: 1:2fI F.3./Fein): 04/30 DRA." BY: B.N. CHECKED BY: T.H.K. SEC. T?i'P. RNG. NOTE: F.I.R.'d. FLOOD ZONE: 'X' . . BEAPINOS BASTED FROM THE NORTH R/WCOtSMU r7TY PA`EL 240: 120075-0001 D LINE OF FORRESTAL CIR. NORTH N.69e31'25%V. DA73 OF F.i.R.M. INDEX: 04-17-89 -FACE CtTRVE DATA: SUMMY ANNOTATIONS: BASE Fif�OD ELEVSTiON: NSA 4 -.11 A o ••FN2.CCN'uo,"INT (No to) -No I TVVAnat ! 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T -ASPHALT 1[SL -fiITGR tA:TER PNT -PONT OF NCH-TANCMCY B -ma.R/o Comam mwAUENT BP250U01 CITY OF ATLANTIC BEACH 2/02/11 Application Tracking Step Selection by Revision 13:38: 15 Application number . . . . 11 00001609 Address . . . . . . . . . . 15 FORRESTAL CIR RE number . . . . . . . . . 171747-0000- - Application type . . . RIGHT-OF-WAY PERMIT NCR OLD ACCOUNT NUMBERS . . AB18004 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 ---- Key Dates --- - Action Summary - Opt Agency description Rev Step Req In Est Cmpl Last Type By _ PLANNING & ZONING A 01 Y 01/31/11 02/15/11 01/31/11 AP SD _ PUBLIC UTILITIES A 01 Y 01/31/11 02/17/11 01/31/11 AP LS PUBLIC WORKS A 01 Y 02/01/11 02/17/11 02/01/11 AP LS Bottom F3=Exit F5=Land inquiry F6=Add F7=Revisions F8=Misc info inquiry F9=Corrections report F10=View 3 F11=Sort by agency F24=More keys