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2243 Beachcomber Trl driveway 2012 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-OfO001068 Date 8/29/12 Property Address . . . . . . 2243� BEACHCOMBER TR Application type description RIGHT-OF-WAY PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc CONCRETE TO PAVER DRIVE/WALK ---------------------------------------------------------------------------- Owner Contractor ------ ----------------- ------------------------ STEVENS WARD F AND JANE E OWNER 2243 BEACHCOMBER TRAIL ATLANTIC BEACH FL 32233 ----------------------------------- ------------------------------------ Permit . . . . . . DRIVEWAY PERMIT Additional desc Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date 2/25/13 ---------------------------------------------------------------------------- Special Notes and Comments Avoid damage to underground water/'sewer utilities . Verify vertical and horizontal location oj� utilities . Hand dig if necessary. If field coordinationi,is needed, call 247-5834 . Ensure all meter boxes, sewer clea�,nouts 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 R�, i concrete box with metal lid. Cleanout to be set and Visible . Full right-of-way restoration, inc'�luding sod, is required. Roll off container company must be� on City approved list and container cannot be placed on ,�City right-of-way. (Approved: Advanced Disposal, Real'�co, Shappelle ' s and Waste Management) Street to be swept daily/as needed to keep dirt out of stormwater system. ------------------------------ ---------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 ENG REV BLDG MOD OR ROW 50 . 00 STATE DBPR SURCHARGE 2 . 00 UTIL REV MODIF OR ROW 25 . 00 1� ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- PERMIT ISPAWAIj4l)FUnY WX(96bRDANCE WIM AAPCITV OF �,TPATWBEACH ORDINANdSQ AND THE FLORHAO BUILDING CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Page 2 Application Number . . . . . 12-00001068 Date 8/29/12 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 79 . 00 79 . 00 . 00 . 00 Grand Total 114 . 00 �-14 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF AfrLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. MAP SHOWING SURVEY OF ipr 91, m-vobWK im,r ow, m mrvollirp M 14X' MIA 4.'�, 0ACA"!; 1, IA, IR, 1c, 11). le Atil) IF Or IT"." (11RIUN-r lluilllr. mr-owl; OF I"iAl, (.1,1NIN. FLORIDA. L 0, 89 -.00 covckcv.,t 0. Cl a Topy 0 CE 0 r 77. nq A41t C-q Af. 43. 50# 26 ...... mov 0 0.02 oc, C C -qo,)I/w en-ekotk IAL PURPOSE SURVIr FOR "rRA '*!f04AT'ip0WC LOCATfom- 11 No (Lows fiffsrRiCTION LINE AS PCR PLAT. 100"ARY DATA AS PgA PLAT. 0116ift" NASAD 00 THE WEST LJKE-OF LOT Of A# R$LAT. j. immy c*.Rrify io Riami) a. & mvxvM, it. aomq.y, Ftmim A FVnl:'Rhf, �SAVIK;S. eANK AM TICOR Mix Y.muwrp viAT i iIAW. W 1-:1) 1,49A Aq SIANN IN 7TIE AIKA-11*-, CAI-i'TCV AM 'MM' MIS ti CITY OF ATLANTIC BEACH CONSTRUCTION PERMIT WITHIN CITY RIqHTS OF WAYAND EASEMENTS 800 Seminole Road 904-247-5800 *It All, Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION. Date PERMIT IS UED BY THE GITY JobAddress Permitee: Z-1 X_ C'v, Telephone Permittee Address: 5--) Requesting Permission to Construct: vyv­� Location: (Reference to Cross-Street) c 1. Applicant declares that prior to filing this application he as ascertained. the location of all existing utilities, both aerial and underground and the accurate locations a4l,shown on the sketches. A Letter of Notification was mailed to the following UtilitiesIM, unicipalities: Jacksonville Electric Authority No�A<Date: Bell South Telephone Company Yes ( D Yes( )11�N Date: Ferrell Gas Yes,(� No Date: Comcast No Date: 2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operaflon, alteration or relocation of all, or any portion of said street or easement as determined by the Director of Public Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately removed from said str4et or easement or reset or' relocated hereon as required by the Director of Public Works, and at the expense of the Permittee unless reimbursement is authorized. 3. All work shall meet City of Atlantic Beach or FloVda Department of Transportation Standards and be performed under the supervision of Akp,C, n Factor's Project C_*,�,_,e",� 1Z,_t C"t 1� 1 14 Superintendent) located at —Telephone 0 IL I I-(,. _S -�G 4. All materials and equipment shall be subject to inspection qy the Director of Public Works or his designee. 5. All city property shall be restored to its original condition a$far as practical, in keeping with city specifications and the manner satisfactory to the city. S. 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 anV 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 pe-mittee must review the permit with the Director of Public Works to make sure no changes have occurred in tt e area that would affect the permitted construction. a. 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, damagp, 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-fbur (24) hours prior to starting work and again immediate n com I tion. OWNER Sign! Date: Before me this day of P�;�ka-cQLeiv-& V L State Of Flo * has person;�aAll eareq SHIREP L.GRAHAM 0 age Juval 'Ay COWAIS ON V DC,9r,77� ,St t Notary X ic a ta f !rida, ountyofDu I M y rx Kn rd 2s si Nloan 'xpiress: RS§�q 9; no Aj. CITY OF ATLANTIC BEACH AVIT OWNER / BULDER AFFID 1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUT S, PART 1 'CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNC WLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7),F-ORIDA 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 OWDIER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DQ NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU BUILD OR IMPROVE A ONE—OR TWO FAMILY RESIDENCE OR A FARM OUTBUILI iING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST 01 $25,000.00 OR LESS. THE BUILDING MUST BE FOR YO &USE AND OCCUPANCY. IT MAN NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE B JILT 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 ONTRA�TOR., 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 q,01 TY OR MUNICIPAL LICENSIN ORDINANC 11. INJURY LIABILITY; SINCE OWNERS MAY BE �R _L!&@jE IES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKqR'S COMPENSATION INSURANCE BE PURCHASED. 111. IRS WITHHOLDING;'OWNERS HIRING WORKERS B COME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 EQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CAqNOT BE EMPLOY D UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,00( PENALTY UNDER FLORIDA STATUTE NO. 455-228(l). AN-O�CUPATIONAL LICENSE' IS NOT ADE UATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LIC=_NSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT. 1; 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. 7) HONE NUMBER ADDRE� PgWT-WME � A ET -6-A—TE SIGN—AlUkE Before me this_JtTday of the county(if Duval,State of Florida,has personally a red herin by himself/herself anc affirms that r .u. all statements and declarations are t5ke a d accurate. Notary Public at Large,State of County f��. aEl P rs nally Known mdo.ced Identification- M IRLEY L(3RAHAM S: DD 957760 Notary Sig re- 11 ruary14 2014 N Notary Pbli, FJBLDG/0�er-Builder Affadavit;REVISED: 16/2009 R.O.W. Permit Attachment of for R.O.W. Permit# issued 200-1 L At. ritic Beach,FL 32233 Owner's Nab 2q_3 f- Tt-L- Property Address: -2 Subdivision: Lot 9/Block R.E. 4: REVOCABLE ENCROACHM*NT PERNUT THIS REVOCABLE ENCROACHMENT PERTvRT, issued on this day of ) 200 ) by Atlantic Beach, Florida, a mu�nicipal corporation organized and existing under the laws of the State of Florida,hereinafter referred to as "CITY" and 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 Beach for the purpose as described in the City of Atlantic Beach Right-of-Way/Easement permit numbers noted above (copies attached). V C 6--b i This work is generally described as: �rj, Any facility maintained, repaired, erected, and/or instal�d in the exercise of the privilege granted li remains subject to relocation or removal on thirty(30) days �otice by CITY to the USER, said notice to USER shall be given by certified mail, return receipt requested, to the following address: The depositing of said notice of cancellation in the Unit�d States mail shall constitute the notice of cancellation and the burden is upon USER to keep the CITY�nfbrmed of USER's proper address. The USER shall promptly make any and all necessal y re airs to any facility erected or maintained in the exercise of the privilege herein granted and shall at all ti�nes maintain said facility in good and safe condition. In the event it is necessary for the CITY or the City's �pproved 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 facilitie�,,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 de requirements of the CITY, including City Code Section 19-7 (h) which states "Driveways that 4-oss sidewalks: City sidewalks may not be replaced with other materials, but must bc. replaced with sm�looth concrete left natural in color so that it matches the existing and adjoining sidewalks." Page I of 2 The USEF, prior to making any changes from the approved plans and/or method, must obtain ity of Atlantic Beach, Public Works Department, for said change. The written approval from the C r USER shall, at the discretion of the CITY, be requested to s4bmit as-built drawings showing the change within thirty(30) days after the day of completion. '11-iis pen-nit shall inure to the benefit of, and be binding upon, the USER and their respective successors and assigns. d CITY USER shall meet the tenns and conditions of this permit'.and to all of the applicable State an laws and/or specifications, to include utilities locate require", ments, and use limitations/requirements of public rights-of-way and other public land. USER C agrees that the CITY and its officers and n , employees shall be saved harmless by the USER froML a 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 day of 20do I ki A i B Prope 0 (to b� signed in presence of the Notary) STATE OF FLOREDA COUNTY OF DUVAL On this day of 2 F-versonally appeared before me, a Notal i the property owner of Public in and for said County State, i 5 Atlantic Be lorida, known to me to be the person(s) descri��in and who executed the foregoing ins=�'; who acknowledged to me that he or she e e ame fr e d voluntarily and for the uses a�d purposes therein mentioned. fill Notary Pu lie in r s ounty 14 014 CITY OF ATLANTIC BEACH, N tary P ljfi� lvldter� 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 City of Atlantic Beach APPLICATION NUMBER AMk Building Deparbwnt (To be assigpned by the BLd*v Dewh") SW Sen*xAe Road Aflanbc Beach, Flonda 32233-5445 Phone(904)247-SM - Fax(904)247-5845 E-mail: bukgrq-dept@coab.us Date routed: cilymob-cife! MIAAWM.emb.us APPLICATION REVIEW ANO TRACKING FORM PropertyAddimss: gmmmr Department review required Yes No , Building Applicant Planning&Zoning Tree AdministraW WublicWo Project rer" Utir -Fu-51-i—cSafety -Pf- 1 V u lic Fire Services 0 Other Aaency Review or Permit Required ne-view or Receipt Date O&F ft Verified By Fbrida Dept of Enviromented Protection FWft Dept.of T St Johns Rhw Water Management District Arnly Corps of Engineers DIvWon of Hotels and Restaurants Division of Ab9mlic Beverages and Tobacco Omer. APPLICATION STATUS RevWMng Department First Review: *Proved. E]Denied. (Circle one.) Comments: BUILDING y:_ Date:ph 9)) PLANNING&ZONING Reviewed TREE ADMIN. Second Review: EjApproved as revi�ed. E]Denied. PUBLIC WORKS Comments: puBUC UTILITIES PUBLIC SAFETY Reviewed 3y: Date: FIRE SERVICES Third Review: E34proved as revi�ed. [:]Denied. Comments: Reviewed �Iy:_ Date:— RNWW 071H118 City of Atlantic Beach APPLI ON NUMBER Building Deparbnent (ro be=*Wmd�by tdtw SuM.m D8PmftWQ SW Seminole Road Beach,Florida 32233Z445 Phom(904)247-5M - Fax(904)247-5845 i Date routed: E-mail: buHdkV-dept@coab.us Oily ws&aife! WA~embma APPLICATION REVIEW Ak P TRACKING FORM Yes No Property Address: Deparovient review required Building Applicant Planning&Zoning Tree AdminisbaW Project: 156blic World_> a ft 944t'6 &)Rlitio, _P551—ic Safew I-r2re Services ;1�mq"IX Odw Agency Review or Permit Required Poviaw or ReceW Date Of termit Veriflied Fbrida DepL of Enviromm"Protection Florida DepL of TmroPoft*m SL Johns Rnrer Water Management District Affny Corps of En*mm Dmm of Hotels arW Restaurarft Divisim of AWKft Beverages arW Tobacco Other APPLICATION STATUS RevWming Deparbitent Fimt Review: UJApproved. E]Denied. (Cirde one.) Cominents. BUILDING PLANNING&ZONING Reviewed by:_ Date: TREE ADMIN. Second Review: []�Approved as revL-01d. [:]Denied. R menft: P U ES k Reviewed Y: Date: C WSAFETY PU E]Approved as revi��. E]Denied- FIRE SERVICES Third Revkm: commenft: F R&i�ewed by: DMe: RWmd 0=18