Permit Pavers 374 1st St 2011 r �
`'y
.E CITY OF ATLANTIC BEACH
I 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
'` INSPECTION PHONE LINE 247 -5826
11- 00001814 Date 3/29/11
Application Number 374 1ST ST
Property Address
Application type description RIGHT -OF -WAY PERMIT
Property Zoning TO BE UPDATED
Application valuation . . • • 0
Application desc
CONCRETE DRIVE TO PAVERS
Owner
Contractor
LECATES JOSEPH OWNER
374 1ST STREET
ATLANTIC BEACH FL 32233
Permit DRIVEWAY PERMIT
Additional desc . Plan Check Fee 00
Permit Fee . . • • 35.00 0
Issue Date . . • . Valuation . . • •
Expiration Date . . 9/25/11
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.
Sidewalk to remain plain concrete.
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
UTIL REV MODIF OR ROW 25.00
Fee summary Charged Paid Credited Due
.00 .00
Permit Fee Total 35.00 35.00 .00 .00
Plan Check Total . .00 .00
Other Fee Total 29.00 29.00 .00 .00
Grand Total 64.00 64.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
r� '� Permit Number: / " 1
Job Address: � C! G-71'
Parcel #
oor �
Legal Description ea o q• t• t
no n- heated/cooled
Valuation of Work $' >/ • I Proposed Work heated /cooled
Class of Work (circle one): New Addition Alteratio Repair Move Demolition pool/spa window /door
Use oe n existing structure, is a fire sprinkler system installed? � (Cir le one): Residential
If No N /A
an structure, N
Florida Product Approval #
For multiple products use product approval form � � •
e of work to be performed: '
Describe in detail the type d 4
Pro er Owner Information: 27 / ` S f S'�
0 S eras C= 4.1-6- Address: J t � /
City r StateJ%tZip LZ3 Phone
City
E -Mail or Fax # (Optional)
Contractor Infor
Qualifying Agent:
Company Name: Phone City State Zip
Office P
Addces Job Site/ Contact Number Fax #
State Certification/Registration #
Architect Name & Phone #
Engineer' s Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Applicatn is. ermit hreby made toall obtain
ork will be performed to meet the standards of all indicated.
ws regulating construction in this jurisdiction This permit becomes l
and void of a permit and commenced that p p
and void if m en fie not erstand that separate per its mor be construction for Electrical Work, Plumbing, Signs, a Wells,P ols, Boilers, Heaters, time after
work is commenced. • ,
Tanks and Air Conditioners, etc. A NOTICE OF
WARNING TO OWNER: YOUR BUR PA Il� RECORD
COMMENCEMENT MAY RESULT IN YOUR FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN C O�ING FINANCING, CO NOTICE OF WITH
YOUR LENDER OR AN ATTORNEY OM NCOEMENT.
� dinances governing this
• I hereby work will whether that I have read and examined this a h e i n and know the m to be au er i
does t. 1 m i g • y
L • t to violate or the
ruing
type e o work tll be complied with whetetheer speci zed d her rein or not. The gr ra g ,f P
provisions of any other federal, state, or local law regulating construction or the performance of construc n
Signature of Owne I -i, , � � � � e/e � � Signatu of r li.; ttiVi
Print Name
' Print Name ��
` -10 /Q. LE e,,,,--5 Prm
Swo ` t4 nd subscribed . fore mf Sworn to and subscribed before me 20
thi ■ ay of . 1 _ 20 1 this Day of
MY C� t l
i 4 .. , .4 , / , ,
Notary Public 111•',....%''-...,' %' 21 2011
EXPIRES: May
. ; P u b underwriters Revised 01.26.10
g g bonded ?hru Nov ta .: .
e
3
"ri CITY OF ATLANTIC BEACH
,''# CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
1� . 904- 247 -5800
r■� ; Fax 904 247 -5845
Atlantic S Beac Beach, 32233 -5445 ad
,�, ' ,�,: � Atlantic Beach, Florida F
Date A• al 21 ZO )/ PERMIT #
,/ ISSUED BY THE CITY
Job Address 3 7T � sr �T�E
permiee: DE
S Telephone #210 r 7 7 � 4 ' 7 3 0
Permittee Address: 3 7
Requesting Permission to Construct: A✓
Pat 1./E r✓a
Location: (Reference to Cross - Street) 5 /4
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:
Date:
Jacksonville Electric Authority Yes ( ) No ( Yes ( ) No (v5 c Date:
Bell South Telephone Company Yes ( ) No (1./r Date:
Ferrell Gas Yes ( ) No (vj Date:
Comcast
Afr
2. Whenever r relocation f of all, or any portion of said street or easement as determined by the Directory of Public
alteration or reloc appurtenances authorized
Works, any or all of sad poles, wires, pipes, cables or other facilities and app
r e ui ede shall Director of Public e Works, from
nd said of the Permittee reset relocated hereon as
unlessreimbu reimbursement is
required by the
authorized.
3. All work shall meet City of Atlantic Beach or S lord Department of Transportation Standards Project
be
performed under the supervision � of 6#er (Contractor's
Superintendent) located at 3/s / 3 Ai/E • Oa 774 )c$ac .i.'w lit. 0CA . 334.0 Telephone #:9
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
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 p than 60 days from date of ermit approval, good faith with /
mittee must review days.
he permit wibeginning
h g the Director of
Public
more t W n or Works days f P
Public Wks to make sure no changes have occurred in the area that would affect the permitted construction.
8. It is un a nd interest in the land to be entered privileges
pon and used by the holder, and the Holder of
all
City's right,
le a
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.
O NER
Vi., / / 444- !,. �'t�+r- Date: 3'� 2/— 2 ''' (
/ O
B f. • . Sr" d ay of # --whin the County of Duval ?
Bd. • th 7,/ r` W `,?,7-(5
State Of Florida, has persona appeared c% S
Notary Public at Large, Stat f• f , 4q ty ' Du / ! , _ - r
My coin xpires: - A' / �° L. I `_:'iyy ,, DEBORAH A. WHITE
P onall : r I i ii ; *_. MY COMMIS k DD 634
entification: i •At EXPIRES: May 21, 2011
' pF q. Bonded Thru Notary Public Underwrfters
R.O.W. Permit Attachment of
for
R.O.W. Permit # issued , 200_ Atlantic Beach, FL 32233
Owner's Name: JOE LE - e7 5
Property Address:
63)..e-11. 61. 327 3
fE.r -nom
Subdivision:
Lot # / Block #:
R.E. #:
REVOCABLE ENCROACHMENT PERMIT
A VHIS REVOCABLE ENCROACHMENT PERMIT, issued on this 2-' day of
,/ 4 2Gf . , 2061, by Atlantic Beach, Florida, a municipal corporation organized an existing
under the laws of the State of Florida, hereinafter referred to as "CITY" and c /63 /-j
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 of the City of Atlantic B a
ech or the
he (copies at descr bed in the City of
Atlantic Beach Right -of -Way /Easement permit num
This work is generally described as: 41/4e- ve7^/
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 the USER, said notice to
USER shall be given by certified mail, return receipt requested, to the following address:
374 /
The depositing of said notice of cancellation in the United States mail shall constitute the notice of
cancellation and the burden is upon USER to keep the CITY informed of USER's proper address.
The USER shall promptly make any and all necessary repairs to any facility erected or maintained in
the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe
condition.
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 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
al sidewalks so that t
replaced with other materials, but must be replaced with smooth concrete
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 the City 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.
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
public rights -of -way 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.
DATED and SIGNED this V day of , 20911
W o p- y Owner
be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF,UVAL
On this `i-4 /'day of 401.0.4/ 2014 per onally appeared before me, a Notary
Public in and for said County and State, CAI SC-�F� ��Z 9 7 , the property owner of
, Atlantic Beach, Florida, known to me to be the person(s)
described in and who executed the foregoing instrument; who acknowledged to me that he or she
executed the same freely and voluntarily and for the uses and • •• - ---- -� ed.
1 DEB�RANA.WHIT6
/ ,, - = aa��'„ � � MY COMMISSION # DD 634126
*i i u r RXPIRSBt M &y 21, 2011
ed lrt ru Nota public U nderw ri ters
'4, 0.`e bond
Notary Public in for said County and State
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:
Jim Hanson, City Manager
Page 2 of 2
VEU APPLICATION NUMBER
ii.:lryr. City of Atlantic Beach (To be assigned by t Building Department.)
d a Building Department MAC 2011
ti -1...' j 1, v 800 Seminole Road
V> Atlantic Beach, Florida 32233 -5445
Phone (904) 247-5826 ' VI :- .� _ Fax (904) Date routed: 2
- '"-toillsY? E -mail: building- dept @coab.us
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
/ . Department review required Yes No ,
v
U
Property Address: �� Building
Planning & Zoning / Applicant: Tree Administrator
Public Works i✓ j
Project: lic Utilities �/
Public Safety
Fire Services '/./
Review fee$ 4 n ° , . 1 * Dept- Signa v� :,,
Review or Receipt Date
Other Agency Review or Permit Required 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:
APP CATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING Reviewed b} Date: .3/ ((
TREE ADMIN. Second Review: ['Approved as revised. ['Denied.
p 4,4 A • - Comments:
`ICU LITIES
PUBLIC SAF Y Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
Public Utilities Plan Review Comments
Initials: J
Date: 3 (I � $� I
f 3r 5fi S� Application Permit #:
Project Name/Address:
.Check Box
•
t0 iklid
Application Tracking Comments
Comment
Avoid damage to underground water/sewer utilities. Verify vertical and horizontal ❑
location of utilities. Hand
if necessary. If field coordination is needed, call
247 -5834.
Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and
visible. Cleanout must be covered
A sewer cleanout must be installed at the property
with an RT1 concrete box with metal lid. Cleanout be °.b��ed if irrigation will be
A reduced pressure zone backflow preventer B,ackflow preventer must be ❑
provided or if there is a private well on the property.
tested b a certified tester and a co sy of the results sent to Public Utilities. �nst�tted
rinkled. if plans change, any Plans note the building will be un.sp ❑ ault and an
must be metered with a Sensus touch-read B�e loo a properly sized be tested by a
appropriate backflow preventer installed. preventer
certified tester and a co .y of the results ta Nla Public Clemons 247 -5839 for
If fire sprinkler system is provided, ❑
bacldlow requirements. At a minimum, will require double check backflow
. eventer.
Fire lines must be metered with a Sens-us touch-read i meter. e Meters larger than 2"
m ust, be installed in a vault as noted in JEA
❑
APPLICATION NUMBER
i +tri� City of Atlantic Beach o be assigned by t Bu Department.)
s Building Department MAR 2 te Ott R
800 Seminole Road I
r } s 1 Atlantic Beach, Florida 32233 -5445 By-__
r � t`
Phone (904) 247 5826 • Fax (904) - =
�- -° • Date routed:
Ji 3 S e E -mail: building- dept @coab.us
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
'/ / V Department review required Yes No
Property Address: 51 7 Building
Planning & Zoning /
Applicant: Tree Administrator
lic Works irj
Project: u is Utilities ,/
Public Safety V
Fire Services '/
RevieVe e$ .4114072rifcAR Dept .,' 4.405A": �
Review or Receipt Date
Other Agency Review or Permit Required 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:
f - )1_ wG-1-z- dv et2-(1-41--$.---- '
��.-, C.
BUILDING /
G & ZONING P- 4/4/7z- ' ~ I Date: 27
PLANNING Reviewed by:
TREE ADMIN. Second Review: Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
Public Works Plan Review Comments
� l
Initials:
3IZ� It ` .gy p
Project Name /Address: 7 j 1 S Application Permit #: I''' &
Check Box
Application Tracking Comments to Add
Comment
Provide impervious surface calculations.
Provide erosion and sediment control plans with installation details and maintenance
schedule.
Provide drainage plans showing site topography (flow arrows, etc.) ❑
Provide construction site management plan, including Right -of -Way Permit if using ❑
right -of -way for construction parking.
Provide a pre - construction topographic survey prepared by a Florida Licensed ❑
Professional Land Surveyor, showing 1' contours.
Section 24 -66(b) of the Land Development Regulations requires on -site storage for
increased runoff. Provide Delta volume calculations and on -site retention required ❑
per Section 24- 66(b). (See attached info. Sheet)
If on -site storage is required, a post construction topographic survey documenting ❑
proper construction will be required.
A Right -of -Way Permit must be obtained for use ❑
A Revocable Encroachment Permit must be obtained. ❑
Pool — Wellpoint (if used) must discharge into vegetated area 10' minimum from ❑
street or drainage feature (swale, structure or lagoon).
All concrete driveway aprons must be 5 inches thick, 4000 psi, with fibermesh from
the edge of the pavement to the property line. Reinforcing rods or mesh are not ❑
allowed in the ROW (Commercial driveways — 6" thick).
Any utility cuts in the road must be repaired using COJ Standard Detail Case X and
must be overlaid 10 feet in each direction from the center of the cut. Repair must be ❑
shown on the plans.
P - Roll off container company must be on City approved list and cannot be placed
on City right -of -way.
(I)/ e.
❑
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