1 W 1 st Street Vet Park Stage 2011 $ '� §, ` . s CITY OF ATLANTIC BEACH
} 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
,, '` INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001856 Date 4/12/11
Property Address 1 W 1ST ST
Application type description COMMERCIAL OTHER
Property Zoning TO BE UPDATED
Application valuation . . . 25000
Application desc
NEW STAGE, FLAGPOLE, SIDEWALK FOR VET PARK
Owner Contractor
MICHAEL G. HOLDER INC
44161 WOODRIDGE DR.
V` CALLAHAN FL 32011
(904) 721 -7676
Permit COMMERCIAL ALTERATION /OTHER
Additional desc .
Permit Fee 175.00 Plan Check Fee . . 87.50
Issue Date . . . . Valuation . . . . 25000
Expiration Date . . 10/09/11
Special Notes and Comments
NEED NOC
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
FLORIDA FIRE PREVENTION CODE
NATIONAL ELECTRIC CODE
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.
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 2.63
STATE DBPR SURCHARGE 2.63
UTIL REV PRE APP >3 HRS 25.00
Fee summary Charged Paid Credited Due
Permit Fee Total 175.00 175.00 .00 .00
Plan Check Total 87.50 87.50 .00 .00
Other Fee Total 30.26 30.26 .00 .00
Grand Total 292.76 292.76 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
.4 BUILDING PERMIT APPLICATION 1*
, CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
C , I
` (DSO Office (904) 247 -5826 Fax (904) 247 -5845 J F �
Job Address: U�r 1 S> ? Permit Number: 11 (0 5
Legal Description A 1-4'7- , CAt/ -t 14 RpyoPl41, /1'I--K Parcel # ..rm(
n a oor ' ea o q. t. q. t
Valuation of Work $ ,ZS 000. Proposed Work heated/cooled non- heated/c l odd ■
I 'rTii °�
Class of Work (circle one): Addition Alteration Repair Move Demolition pooUspa „s c
Use of existing /proposed structure(s) (circle one): tComn rci Residential &61 z 0 E
If an existing structure, is a fire sprinkler system inst (Circle one): Yes No all G pa H A
Florida Product Approval # U U A O q
For multiple products use product approval form W g A A
Describe in detail t h e type of w o r k to be performed: C P I (.l 5777 u/41 A. 5 , Go AJ - _ ,:.17 • , f 4
9►- a D ,5 a w
Property Owner Information: W W* U w
blame: 6Tf b P An-M.47 6 13 C47-14 Address: ro o 5 i i,t/o L-- E Z7 A ? 'at'
City All- 3 "eN State Pi-Zip 3/143 Phone 9 0 4 Z 4 7- S 8 34' iCrl A
E -Mail or Fax # (Optional) f f 9 ! l Co C ea lei, 0$
Contractor Information: /
C o m p a n y Name: N'. / a i- b I'- D - /4/e... Qualifying Agent: /fitc /M'P L A -- r�
Address: 74 _Si c - 8/61,,1 - / E 714-- , City -- lA-ex sev✓ic,t State ,z Zip .3 1244
Office Phone ?o 4 - 72/ - 76 710 Job Site/ Contact Number `,9.1--2.19- 4I a 3 Fax # 90# 7 2 — 7 4 er
State Certification/Registration # G /3 G - 0 4 4 7Z-4-
Architect Name & Phone # V14 Go */• E173 1°04- 2- 49 - 990 0
Engineer's Name & Phone # 4417rvDE 30 Eu4 /iWE 9 0* - Z # 7 - //SS
Fee Simple Title Holder Name and Address
Bonding Company Name and Address /I EKctrA io�i /Akf en., PAY 2 IC o A FUR- Pg.. PO 1 i■ES /mil 5 /
Vlortgage Lender Name and Address
4pplication 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
znd void zf work is not commenced within six (6) months, or if construction or work is suspended or abandoned for gperiod of six (6) months at any time after
vork is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters,
ranks and Air Conditioners, etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
CONIlVIENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
ype of w ork will be complied wit hether specif ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
?revisions of any other federal, s or local law regulating construction or the performance of construction.
>ignature of Owner Signature of Contractor 7/ -.-
rint Name " / i , C . C42/ , / ' /; c Print Name A l -01'M- l '• d �D .
;worn tch Ind subscribed before me Sworn t2and subs 1. - . ;; or Puai c Ws of flora'
his .Q4 - May of /Y1,�,ee e , 20 ! this 1 _Day of i': - r. Buck Wiseman 20 /
- ■ �_ �� MY Commiss 11 met
7
— 011
` ►r, 4 . Notary Public State of Florida urn
;otary Public V' ; Buck Wiseman Notar Public '"""
My Commission DD739661
f or a Expires 12/05/2011 Revised 01.26.10
, , iy�,� r City of Atlantic Beach APPLICATION NUMBER
- r
���
:10'01,1 (To be assigned by the Building Department)
�$ Building Department
800 Seminole Road
1 ; 1 Atlantic Beach, Florida 32233 -5445 tfiS4ft
1/
Phone (904) 247 -5826 • Fax (904) 247 -5845
a l sP. E -mail: building- dept @coab.us Date routed
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
1
Property Address: Department review required Yesl No
Buil• .. V
b � ) Planninq & • - g
Applicant: O/ h �/I GF�L. / 1 o ( fie / /✓� Tree Administrator
Project: / a th A2 A)/t/ � r /�9 /d �� .�n�it�iR•T��
9 i blic Utili
Public Safety
Fire Services
°'',�k"'r, " -`'se^ < �1 s r � '![ "$' s t•i _",75. aS; ,� W7717:
,i T ru z+ �` 1
Revlew fee $ ~�� ., l a � �; Deft. S ) b. ? i _ kAi:1:;..54:6;
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:
BUILDING
PLANNING & ZONING Reviewed by: in Date: 1Z_
TREE ADMIN. Second Review: ❑Approved as revised. ❑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 ' j� APPLICATION NUMBER -
(To be assigned by the Bu Department)
Building Departmen MA,
q ,��;V 800 Seminole Road q ,
-Tea �r Atlantic Beach, Florida 32233 -5445 ,
-
- Phone (904) 247 -5826 Fax (904) 247 -5: Date = T
routed F �-
-o,t �r E -mail: building- dept @coab.us C. �- • -� -. - . --
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
L
Property Address: _ `) j4/ clf De • artment review required Yes No
// Buil.'m.
Applicant: `�✓/ )i C/1 LEL. T6 (/ iA �/✓�' �P -nnin• & •-' g
, -� Tree Administrator
Project; i Ai/t),1//' Y' �Qy" to 6 dcWor c Utilit
Public Safety
Fire Services
IL Zr , , i � S :PLIMAan7 o'i g7nl b '7 ;q.� ,401/4
Revlewfee $ � ltiMM iii �;.�F De tKbl i)atiggi:.. t
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: /� pproved. EDenied.
(Circle one.) Comments: ("
BUILDING
PLANNING & ZONING Reviewed b Date: ,3 —. 30 �//
TREE ADMIN. Second Review: Approved as revised. ❑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
i =w L!j,, City of Atlantic Beach M
APPLICATION NUBER
S ` " Building Department (To be assigned by the Building Department )
r _'� i 800 Seminole Road : �`
r ' ' .. Atlantic Beach, Florida 32233 -5445
'' ' °: Phone (904) 247 -5826 •Fax (904) 247 -5845 �„ :,
*"v Jj; , Date routed '
r E - mail: building- dept @coab.us .. _:.. - _. ' , 2;1E.,
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
L
Property Address: _ G) ��/ ., De artment review required Yes No
/ 1 Buil' s!
V �
Applicant: J, / t
(EL T/ � (d/fe ti✓G � & • • • g
Applicant: ,,,,%% - � Tree Administrator
Project: / C �.. 67 J 264.1/3/!✓ f`" /Q " t v / . •1n:7t [•Ti
Public Safety .
Fire Services
eviewmfee �_ : ; 't a , D,_.e tfSf l ri' i ,' « ` 5 { k r
.. 9 La � z r al xt,,.�.,� _ si eJsty ..._
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: e pproved. EDenied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING, Reviewed by: Ji.1), Date: 3 — 3/2/i
TREE ADMIN. .
Review: Approved as revised. @Dened.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: EApproved as revised. (Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic Beach � 'APPLICATION NUMBER
JS ^;
Building Department (To be-assigned by the Building Department )
a S� 800 Seminole Road - /
154 �r Atlantic Beach, Florida 32233 -5445 Phone (904) 247-5826 • Fax (904) 247- '. ��
y a I
'•:Qt
S - E -mail: building- dept @coab.us Date routed
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TR KING FORM
L
J r tment review required Address: /(,) /6r 4T- De • a uired Yes No _ — q
Buil••a •
Applicant: L )?/ Oh / t'/IA / / 1 / 4 Y Planning & 7. • ig
Tree Administrator
Project: 1 AiAJ ,T/� /ay /�. lic Wow
Public Safety
Fire Services
a er a a rats ris
Revie $ 4;fe ... 041410301-
.. , 3 - 0 6pt Signature ri r 's
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: �(JApproved. EDenied.
(Circle one.) Comments: �' \\
p� 4/ / /• ti
BUILDING /
PLANNING & ZONING / 3 ?1>)1
Reviewed by: I Date:,
TREE ADMIN. Second Review: ❑Approved as revised. ['Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. rlDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
04/14/2011 12:19 FAX 9047217685 MICHAEL G HOLDER, INC. t1001/002
+fir
r =.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001856 Date 4/12/11
Property Address 1 W 1ST ST
Application type description COMMERCIAL OTHER
Property Zoning TO BE UPDATED
Application valuation . . . 25000
Application desc
NEW STAGE, FLAGPOLE, SIDEWALK FOR VET PARK
Owner Contractor
MICHAEL G. HOLDER INC
44161 WOODRIDGE DR.
CALLAHAN FL 32011
(904) 721 -7676
Permit COMMERCIAL ALTERATION /OTHER
Additional desc .
Permit Fee . . . 175.00 Plan Check Fee . . 87.50
Issue Date . . . Valuation . . . . 25000
Expiration Date . 10/09/11
Special Notes and Comments
NEED NOC
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
FLORIDA FIRE PREVENTION CODE
NATIONAL ELECTRIC CODE
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.
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 2.63
STATE DBPR SURCHARGE 2.63
UTIL REV PRE APP >3 HRS 25.00
Fee summary Charged Paid Credited Due
Permit Fee Total 175.00 175.00 .00 .00
Plan Check Total 87.50 87.50 .00 .00
Other Fee Total 30.26 30.26 .00 .00
Grand Total 292.76 292.76 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
[7j002/002
04/14/2011 12:21 FAX 9047217685 MICHAEL G HOLDER,INC. PAGE 02/02
04/14/2011 11:32 9042475843 ATLCBEACH CITY WORKS
NOTICE OF COMMENCEMENT
State of .o.._, Tax Folio No.
County of
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,
the Florida Statutes, the following information is a in 's NOTI9 COMMEN EMENT and in a rdance with Section 713 of
Legal Description of property being improved: et �,v�rf. /A k
Address ofproperty being improved: 0 G1e-- /2
G e n e r a l d e s c r i p t i o n of i m p r o v e m o a t e C G?4 t S - e. G-J1
` . I �.e w
Owner: e 4.7 eti . 14_44, � llob.m,. Address: 6 ,,,,, �C ? 2?,.�.?
er's interest in site of the improvement:
Fee Simple Titleholder (if other than owner):
Nozzle:
Contractor: /
Address: 2 V/" 2 5 f/¢a. r?n( J� .tJ < n f� u
� � �- ? -z.z it
Telephone No.: '2,1 ( 7 (h A Fax No:
Surety (Warty) ., [ • C t5 .
Address: ), /t%2) /ee. ikft. 19/t 1 Vs 0v,..) / Z ,.s ofBond S ? 6-210
Telephone No: Fax No:
Naive and address of any person maidng a loan for the construction of the improvements
Name: 0/4'.
Address:
Phone No: Fax No:
Nano of person . '. the State of Florida, other than himself, designated by owner
� � • C upon whew notices or other document may be
served: Name: at ' ,�. C. P 9) /( War1,S rrt t eTt},�
'Address: ! W k. ��.aw �..w 414 ) A. kit 1 ?
Telephone No: 7 0144.- 3 y 7 . $ / J Y Fax No: P° — 2V ? - S J Y�
In addition to bimseli; owner designates the following person to receive a copy of the Liener's Notice as provided in Section
713.06(2)(b), Florida Statues. (FBI in at Owner's option)
Name: __,_� t�v+.t a. .le•.R
Address:
Telephone No: Fax No:
Doc s 20110/20M, OR OK tSi Pagel. ration date is one (1) year from the date of recording unless a different date is
Number Pages: 1
Recorded 03,3012011 at 02;30 PM.
J1M FULLER CLERK CIRCUfT COURT DUV.AL
COUNTY
RECORDING 510.00 geed: '.!� = ]date: //
Fore the . ' / o , day of "1ePr1ls. , in the C ty of Duval, State
of Florida, bas personally appeared
. � EBORM - i. fE Notary Pubarge State of Ftertda, Coup , of Duval
. Mv0ooelrt%
� My Public at l ..
• Miy 2i, 201 } :.. or
_ -. _ •• •� � .erttrfic�tio
,#I i / //i
PROJECT NO: 1208 -0001
BilS&ASSOChte$1 K LAB NO: 62329 -A
DATE TESTED: 62329 05/02/2011 A
7064 Davis creak Road REPORT NO: 1-0003
Jacksonville, Fl 32258 DATE: 05103/2011
(904) 880-0960 Office
(904) 880 -0970 Fax
REPORT OF: IN -PLACE DENSITY TEST
PROJECT: Veterans Memorial Park
10 W 1st Street, Atlantic Beach, Duval County, FL
ATTENTION: BUCK WISEMAN
REPORTED TO: MICHAEL HOLDER INC
44161 WOODRIDGE DRIVE
CALLAHAN, FL 32011
TEST RESULTS Page 1 of 1
General Location: New Platform
Speclflc Location: New Platform Pad
Course: Fill Dry Percent
Test Percent Density Proctor Spec Proctor
Test Depth No, (in) Location Moisture (pcf) Number No. Density Pass/Fall
1 12 Center 8.6 99.7 62329 1 97 Pass
Proctor Proctor Optimum Maximum LBR
No Date Moisture Dry Density Value Description Location
62329 05/02/2011 14.8 103.3 N/A Brown Fine SAND with Hardpan Stockpile
Specification
Specification No. Compaction, %
1 95-105
Date Received: 05/02/2011 Date Tested: 05/02/2011
Gauge No.: 34218
Test Methods: ASTM D6938 -08a
ON: MICHAEL HOLDER INC Attn: BUCK YyISEMAN (1-cc copy) Respectfully Submitted,
EIIIIs & Associates, Inc.
L\ DRAFT
Joseph M. Champion, P.E.
Technician: Adam Jackson Director, CMT and Inspection
Licensed, Florida No. 69135
This REPORT APPLIES ONLY TO THE STANDARDS OR PROCEDURES INDICATED AND TO THE SAMPLE(S) 'TESTED AND/OR OBSERVED AND ARE NOT NECESSARILY INDICATIVE OF
THE QUALITIES OF APPARENTLY IDENTICAL OR SIMILAR PRODUCTS OR PROCEDURES, NOR DO THEY REPRESENT AN ONGOING QUALITY ASSURANCE PROGRAM UNLESS SO
NOTED. THESE REPORTS ARE FOR THE EXCLUSIVE USE OF THE ADDRESSED CUENT AND ARE NOT TO BE REPRODUCED WITHOUT PIT WRITTEN
CREATED P SS � T $ Tf A