30 17th st 2013 row Applica :ion Number . . . . . 13-00003137 Date 8/05/13
Propert,''7 Address . . . . . . 30 17TH ST
Applica :ion type description RIGHT-OF-WAY PERMIT
Propert,'7 Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
PAVER DECK AND WALKWAY
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Owner Contractor
------------------------
------- -----------------
DOWLIN DIANE M & WILLIAM A OWNER
30 17TH STREET
ATLANT= BEACH FL 32233
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Permit . . . . . . DRIVEWAY PERMIT
Additional desc . -
Permit Fee . . . . 35 . 00 Plan Check Fee . 00
Issue Date . . . . 8/01/13 Valuation . . . . 0
Expiration Date . - 1/28/14
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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 .
Ensure all meter boxes, sewer cleanouts and valve covers
are set to grade and visible .
Pavers must be installed over crushed aggregate base
(#57/#8 stone) per ICPI Technical Specification 18 .
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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
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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 79 . 00 79 . 00 . 00 . 00
Grand Total 114 . 00 114 . 00 . 00 . 00
City of Atlantic Beach 7' ,IVED APPLICATION NUMBER
Building Department At 3 0 2013 (To be assigned by the Building Department.)
800 E eminole Road
Atlan-ic Beach, Florida 32233-5445
- Fax(904)247-5845
Phon�(904)247-5826 Date routed: -7 z9
E-ma 1: building-dept@coab.us I
City v Feb-site: hftp:/Iw".coab.us r
APPLICATION REVIEW AND TRACKING FORM
De nt review requireda Yes No
Property Address: 3a uil * 6� --
ng &Zoning
rE m a, f or
Applicant: Ominisraor
Project:
as
Public Safety
Fire Services
Review fee Dept Signal
Other Agency Review or Permit Required Review or Receipt Date
of Permit
FloridE Dept.of Environmental Protection
FloridE Dept.of Transportation
St.Jot�s River Water Management District
Army orps of Engineers
Divisioi of Hotels and Restaurants
Divisio ri of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: [:]Approved. Denied.
(Circle one.) Comments:
P—)
BUILDING '�--" " L",
PLANNING &ZONING W)a-\v2z� Reviewed by: Date:
TREE ADMIN. Second Review: Approved as revised. [:]Denied. CV
PUBLIC WORKS Comments:
PUBLIC UTILITIES f—
kg,24>' Date: op—)
PUBLIC SAFETY Reviewed by:7;%;z — —
FIRE SERVICES Third Review: N?"pproved as revised. []Denied.
Comments: �v Y,
Reviewe4L��—�Date:s--/- 13
Revised 05114109
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 �eminole Road
�ic Beach, Florida 32233-544
Atlan I
Phon 3(904)247-5826 - Fax(904t-
A E-ma 1: building-dept@coab.us Date routed:
Cityweb-site: hftp:/Avw.coab.us
APP ICATION REVIEW AND TRACKING FORM
Property Address: 1-7rw J7 D
ppaAm@nt review required Yes No
A,uildin
Applicant: gannin &Zoning_�
ree Administrator
Project: 06 ilt Public Works
AM Public Utilities
I Public Safety
Fire Services
Revie N fee$ Dept Signature
OtherAgency Review or Permit Required Review or Receipt Date
Florida )ept.of Environmental Protection of Permit Verified By .00
Florida )ept.of Transportation .00
St.Johr is River Water Management District
Army C)rps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
APPLICATION STATUS
Reviewing Department First Review.:::�Pp oved. E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONINC- Date: 4
Reviewed by: =966"140
TREE ADMIN. Second Review: EJApproved as revised. nDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 06114109
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 1,0 / 7 7`
Permit Nu r: 2-9 2013
Legal Description Parcel#
Floor Area of Sq.Ft. _Sq.Ft
Valuation of Work$ Proposed Work heated/cooled non-heated/cool�e
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structureW circle one): Commercial Residential
If an existing structure,is a fire sprm=system installed? (Circle.one): Yes No N/A
Florida Product Approva.I#
For multiple products use�r_oduct approval for—m
Describe in detail the e of work to be performed: 1)
Property Owner Inform,iti
Ai_� Pla__N
Name: I -I W - 7 S7_
City A�L_A Statef
LZip ZY223-�Fhorie A 9
E-Mail or Fax# (Optional) Id 6 Y
Contractor Information:
Company Nanwo;v '7 JI) /46-:�0_4ualifyinp�gent:
Address: Lr 41) city L —State Zip 32-2-dS
Office Phone Job Site/Contact Number .") —Fax#-
State Certification/Regisbation# �f;6 41 :2 k-73���
Architect Name&Phone 9 'r.- C7
Engineer's Name&Phon-,#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application 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
issuance of a permit and that a,I work will be performed to meet the standards ojrall laws regulating construction in thisjurisdiction. This permit becomes null
and void ffwork is not commer ced within six(6)months, or if construction or work is suspended orabandonedfor a eriod ofsixP5)months at any time after
work is commenced I under�tand that separate permits must be securedfor Electricar Work,Plumbing,Signs, Wells,Pools, urnaces,Boilers,Heaters,
Tanks and Air Conditioners,e 1c.
WARNI G TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENIE�ER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
Ihere certify that I have reaS and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
wor
711 k will be coTplied with whethersrecifz'ed ere* or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any otherfederall state, or loca aw re at' construction or the pe�fbrmance of construction.
SignAure of Own�2_ le ?�nature of Contractor
e-D-0 W C_ ,A) Print Name
Print Name �act.or
....................................................... ........... . ... ........................... ... .........................................................................
...............
Before me B f f
je 01��e
this Day of 20 thi ay of 20
'Iary-M c
Nd-tff7T4,ffi c
Notai37u-blic
Revised 10.24.12
CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
800 Seminole Road 904-247-5800
Fax 964-247-5845,'
Atlantic Beach,Florida 32233-5445
iwow
PLEASE SUBMIT(3) OMPLETE SETS OF PLANS WITH APPLICATION.
ABMIT(3) I
Date k� 11 PERMIT#
;s
I ISSUED BY THE CITY
Job Address 1-7
Permitee: e, Telephone# 67
Permittee Address:
RequestiV Permj slo t Construct:
,c.r 2f
Location: (Reference to Cross-Street)
1. Applica t declares that prior to filing this application he has ascertained the location of all existing utilities,
both aeial and underground and the accurate locations are shown on the sketches.
A Lettei of Notification was mailed to the following Utilities/Municipalities:
Jackso ville Electric Authority Yes 0 Dat
Bell South Telephone Company Ye,
Ferrell Gas Ye N
te:
Comca.st Yes o
2. Whenever necessary for.the con'str uction, repair,, improvement, maintenance, safe and efficient opera'tion,
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
require 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 qu p ent of Transportation Standards and be
f lorida De
performed under the supervision of Jwge, 1&rr4s Contiactoe6' 'Project
Superirtenclent) located at Telephone#:
4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee.
5. All city Droperty shall be restored to its original condition as far asp,ractical, in keeping with,city spe.cific.ations
and the manner satisfactory to the Pity,
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 his permit. talculations showing any increase in impervious area on owner's.lot.or in the-city
Riaht(f Wav are to be included with this application. begihni ' date'is
7. This pe rmittee shbIlcorTimence.actual construction in good faith With clays.� 'If the ng
more tI ian 60'days'from date of permit approval,�then Oermittiae 'must rbvieW'the permit with the Director of
Public I Vorks to make sure no changes have occurred in the area that would affect the permitted construction.
8. It is un Jerstood and agreed that the d4hts'and"Orivile'g' ds herb'ifi';s6i�ciut are granted only to the extent of the
t 1,
Hol!clerwill, 1; all
City's r ht, title and interest in the land to be entered upon and.used by.the holder, -nd the r "a
times, issum e:all risk .of the City of Atlantic Beach: from-and
and indemnify, defend, and save harmless
against any and all loss, damage, and cost of expenses arising in any manner of the exerciseiorattem,pted
exercis�.s by the holder of the aforesaid rights and privileges.
(24) hours prior to starting work and again
9. The D.-ector of Public Works shall be notified twenty-four
immediately upon completion.
07Ell
igr ied: qWl
Be re me thi d9y of in fhe CcFunty of Duval,
Sta Of Flori h s personally ap dar d
on
No U a La e ateipf oriop:Inty of D
S LR
My x r s: HIRLEY L
L�LIB&V"Ily Knii
�W.DD.957760
IRES:Februaty 14,2014
Thru N". Ptf*Und rms
R.O.W.Perini Attachment of for
R.O.W.Perini # issued 20_ Atlantic Beach,FL 32233
Owner's Name: 001.2111(l
Property Address: 30 171h- MMeae
A-k .
Subdivision:
Lot#/Block#:
R.E. #:
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of
—, 20_, by Atlantic Beach, Florida, a municipal corporation organized and existing
under the law,,� 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).
This work is genera y described as: P&vec e�rj'aew,�_ &,�Jkw47 , A
hA_QK___?A,
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:
The depoE iting of said notice of cancellation in the United States mail shall constitute the notice of
cancellation a ad 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 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 ente 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 facili ies 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 sidewalks: City sidewalks may not be
replaced with other materials, but must be replaced with smooth concrete left natural in color so that it
matches the eKisting and adjoining sidewalks."
Page I 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, a.the discretion of the CITY, be requested to submit as-built drawings showing the change
within thirty (.'10)days after the day of completion.
This permit shall insure to the benefit of, and be binding upon, the USER and their respective
successors and assigns.
USER sha'.1 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 shill 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 day of 9-7-* 201-3
B Y;r4( 'A, C:,
Prop Owner
(to be si ed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this __L_ day of 20, personally appeared before me, a Notary
Public in an I for said �ointy (Ind State, , the property owner of
. Atlantic Beach, Florida, known to me to be the person(s)
descr7ibd in nd who executed the foregoing instrument; who acknowledged to me that he or she
exe kd th s e f] el n olu tar' y and for the uses and purposes therein mentioned.
F n 0 tar- y a
t
6and
S
0
y 4( S
- - - - -- ------ -
NoTM�l ublic ii�for I Co and t SHIRLEY L GRAHAM
.AY COMMISSICIN#DD 95776(i
st
C LO I
RI EXPIRES:February 14,2014
CITY OF ATLANTIC BEAC LOR WOO Thru Notary Public Undmwiters
municipal corporation:
ApX��,
Ricky L. Carfer,Public works N4�tor
For Permits here city sidewalk is impacted,
City Manager approval required:
)o A—
Jim Hanson, C ity anager
Page 2 of 2
_30 17:6, sk eer,,f-
Impervious Surface Calculations % formula/50 % allowable
coverage only
In square footage — House footprint 450
Driveway — 23 0
Sidewalk (walkways) — 175
A/c pads — 16
Detached garages or sheds —
Pool decking - �J/4
Add totz I square footage of the above and divide by total lot
area :9�7
2-750
...........
S�3
30 17TH ST EXISTING ISA RATE TOTAL
HOUSE 953.38 100.00% 953.38
DRIVEWAY 120) 492.20 100.00% 492.20
WALKWAY 56.25 100.00% 56.25
PATIO 174.00 100-00% 174.00
A/C PADS 27.00 100.00% 27.00
1702.83
TOTALLOT 2750.00
ISA COVERAGE 0.62
PROPOSED ISA RATE TOTAL
HOUSE 953.38 100.00% 953.38
DRIVEWAY 492.20 100.00% 492.20
WALKWAY 2-0 -429.15 50.00% w m. 130
PATIO 174.00 50.00% 87.00
A/C PADS 1�- 100.00% 474)9- Ls
1724.16 16,R'O,
TOTALLOT 2750.00
ISA COVERAGE 0.63
MIAP SHOWING B0UNrlL-)"ARY SURVEY OF
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FGohng-the DISTANCE for C.1
4613 Philips Highway.Sulte 210 PONTEVEDRAJITLE,
JacksonAlle.Flodda 32207
(Phone)904-448-5125
(Fax) 904-448-5178 +
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4613 hillps Highway.Suit
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Jarksonville,clorida 32207
(Phone)904-1448-5125
(Fax) 904-443-5178
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