2359 Seminole Rd (vault) CITY OF ATLANTIC BEACH PERMIT
APPLICATION #
S1 WELDING I 'ZONING DEpARTMENT
100 Seminole Road
Manti -'ia32233
c Beach,Flo
(904)247-5900
(904)247-5845 1
wwvv.coab.us
APPLICATION TRA' XING FORM EQUIRED DEPT:
N PLANNING
N_ BUILDING
z
SIM jW,#
Property Address.
N PUBLIC WORKS
Applicant-- 0 y N PUBLIC UTILITIES
y N FIRED'EPT.
y N PUBLIC SAFET Y
-project:
U) -APPROVAL INI DATE
ui RECEIVED BY:
C.) rXE IRED AGENCY:
Z Lu D.E.P HUFSTETLER
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APPLICATION S us
CIRCI F ONE: sITE BUILDING DA AP REVI D B INITIAL: DATE:
I ST REV 17,
PLANNING
UD2ND REV
ILDING
PUBLIC WORKS
PUBLIC UTILITIES
FIRE DEPT.
PUBLIC SAFETY 3RD REV
T;��ihm irn*hiQ fnrm f"iba-11111iilgii-Ru vnu have entered vour comments into the AS400.
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H
CITY OF ATLANTIC BEAC 08
800 SEMINOLE ROAD,ATLANTIC BEACH.FL 32233
OFFICE:(904)247-5826 0 FAX No.:(904)247-5845
BUILDING-DEPT@COAB.US DUVAL COUNTY
BUILDING PERMIT APPLICATION
2.VALUATION OF FT,UNDER ROOF
:1.JO B ADDRESS:
.�?.3 61 5.CLAS'OF WORK�` U F STRUCTURE:
4.LEGAL DESCRIPTION: El NEW BUILDING [3 DEMOLITION RESIDENTIAL
WOADDITION E3 coNvERnNG USE [I COMMERCIAL
LOT—BLOCK. SUB DIVISION U ALTERATION [I ACCESSORY BLDG. 8.FIRE SPRIN A
DESCRIPTION OF WORK: REPAIR 0 Poo OYE
��SPA
ER 0
A 0 6.5wr (I MOVE or CT I ENGINEER:
PROPERTY OWNER: vk^c rOR- 23.COMPANY NAME:
15.COMPANY NAME:
9.NAME:
24.LICENSEE NAME:
17.STATE 0 RIDA LICENSE NO.: 25.zi a A I E OF ru
10.ADDRESS:
7--3-51 seminole- Roa�- 18.ADDRESS: 26.ADDRESS:
tl--11+6xi7l�c a213:1
19.OFFICE ii5iii................... ....I'll 20.FAX NO.: V.OFFICE PHONE: 28.FAX No-'.
11.OFFICE PHONE: 1Z FAX NO.:
dtvq--,Iq-2-0 t 110 q0%-2.0m-0 I'll 21.CELL PHONE: 29.CELL'HONE:
13.CELL PHONE:
04-400 --LZ-15 22-EMAIL ADDRESS: 30.EMAIL ADDRESS:
`14,EMAIL ADDRE55,
CLC-abso czwlrots.C,0*1 MORTGAGE LENDER:
FEE SIMSP LE HOLDEW. BONDING COMPANY:
(W OTHER TvJAN OWNER) 35.NAME:
33.NAME:
31.NAME:
36.ADDRESS:
34.ADDRESS:
32,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
the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this
commenced prior to onths, or if construction or work is suspended or
jurisdiction. This permit becomes null and void if work is not commenced within six (6)m parate permits must be secured for
abandoned for a period of six (6) months at any time after work is commenced. I understand that se
ces,Boilers,Heaters,Tanks, Air Conditioners,etc.
Electrical Work,Plumbing,Signs,Wells,Pools,Furna
T-I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
OWNEWS AFFIDAVII ning.I Will not occupy Or use the referenced building or any part therof,until all inspections are finaled and
laws regulating construction and zo etion issued by the building official,as required by law.
prior to obtaining a cerfificate of occupancy or coinpi
WARNING TO OWNER: C.�
MMENCEMENT MAY RESULT IN YOUR
YOUR FAILURE TO RECORD A NOTICE OF CO
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
POSTED ON THE JOB SITE BEFORE THE
COMMENCEMENT MUST BE RECORDED AND
FINANCING, CONSULT WITH YOUR Willow
FIRST INSPECTION. IF YOU INTEND TO OBTAIN OTICE OF COMMENCEME IT.
E RECORDING YOUR N
LENDER OR AN ATTORNEY BEFOR
CONTRACTOR
OWN R or AGENT (Quaffiff Orgy)
(If AgenL Power of AttOMeY or Agency Letter Required)
Date:
'ENT
ate: Signed: co
Signed: ' Before me this_day of 2007 in the lcountyof
Before Me -:5-12, d y of 2007 in the county of Duval,State of Florida,has personally appeared
Duval,State of F"a,has personally appeared
!�. rat on.a me
herin by himself/herself and affirms that all Statements and declarations are herin by himself I herself and affirms that all statements and declarati ns a
true and accurate.
true and accurate. County of
N ta Public at Large,State of County of Notary Public at Large,State of
0 Personally Known
k7p.."nally Known 0 Produced Identification-
0 Produced Identification- Notary Signature:
Notary Signature:
REVIF,1NI&L- FOR CODE COMPLIANCE
CITY OF ATI,ANTIC BF-ACH
ou MW
SFE PERMITS-FOR ADDITIONAI,
COAB ND CONDITIONS
ORM REQUIRETA� 1,
0 0034331S DATE. r11114f
REVIEWED M
_1A J'J PERMIT
CITY OF ATLANfIC BEACH F=
;LIC
N'T APPLICATION#
BUILDING / ZONING DEPARTME
F) no Seminole Road
Mantic Beach,Florida 3223 3
47-50-00
(904)2
Dill (904)247-5845 Fax
www.coab.us
APPLICATION TRACKING FORM
REQUIRED DEPT:
N PLANNING
N BUILDING
Property Address: 62.3.6�q Selo iv#zi, z MING
BUI VVO
I-_ N pt,Uu B0 LL11 Cu Vv VVOIJ RKS
TJ
0 y N PUBLIC UTILITIES
AppUcant-- (xat LX =P
Y rNFIREDEPT.
Project: y N PUBLIC SAFE,Y
-APPROVAL DATE:
w RECENED BY: INITIAL
0 IRED AGENCY: HUFSTETLER
Z
w w", N D.E.P
< Y N S.J.R-W.M- CARPER
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APPLICAT ION STATUS
CIRCLE ONE SITE,_ BUILDIN DA AP REVIEWED BY: INITIAL: DATE:
PLANNING 2ND REV
BUILDING
PUB C WORKS
B G WO
PUBLIC UTILITIES
FIRE DEPT.
PUBLIC SAFETY
3RD REV
nnee vnift hgve entered vour comwcnts iutO the AS400
CITY OF ATLANTIC BEACH 08-
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233
OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845
BUILDING-DEPT@COAB.US
BUILDING PERMIT APPLICATION DUVAL COUNTY
1.JOB ADDRESS: 2.VALUATION OF WORK: 13.SQ.FT.UNDER ROOF
6.U5R<F STRUCTURE:
4.LEGAL DESCRIPTION: S.CLASS OF WORK:
0 NEW BUILDING 0 DEMOLITION FRESIDENTIAL
LOT BLOCK SUB DIVISION 11 ADDITION 0 CONVERTING USE 11 co
7.DESCRIPTION OF WOk� 0 ALTERATION 11 ACCESSORY BLDG. 8.FIRE SPRINKLERZ
_J0 6 U P020�L�J-S 0
0 REPAIR 0 A
0 MOVE W&iER 11940
PROPERTY OWNER: CONTRACTOR: Arml I��I,ENGINEER:
1 S.COMPANY NAME: 23.COMPANY NAME:
9.NAME:
I-
juj-4k 16.NAME: 24.LICENSEE NAME:
10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.:
2.3.51 'Se-mi 18.ADDRESS: 26.ADDRESS:
A-1 6wj�C�� IF L 2,2-13
t7t--T I
11.OFFICE PHONE: 12.FAx NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28,FAX NO.:
C(C24-2-q*Z-6110 1q0L1-2'Ct7--61%9 1 1
13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE:
-104-4-00 -2.2-45 30.EMAIL ADDRESS:
14.EMAIL ADDRESS: 22.EMAIL ADDRESS:
?a-C-41-1-0 V1 e-e.A cz-wi Is.COwl
-44 FEE SIMPLE TITLE HOLDER: BONDING COMPANY: MORTGAGE LENDER:
(IF OTHER THAN OWNER)
31.NAME� 33.NAME: 35.NAME:
32.ADDRESS: 34.ADDRESS: 36,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 all work will be performed to meet the standards of all laws regulating construction in this
jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for
Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc.
OWNER'S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
WARNING TO OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
OWNER or AGENT CONTRACTOR
(if Agent,Power of Attorney or Agency Letter Required) (Qualifier Only)
ate: Signed: Date:
Signed:
2007 in the county of
me -5� day of 2007 in the county of Before me this
Before $ehs--:45 day of
Duval,State of Florida,has personally appeared Duval,State of Florida,has personally appeared
herin by himself/herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are
true and accurate. true and accurate.
N t Public at Large,State of County of IJ&V4L� Notary Public at Large,State of County Of
t��Personally Known [3 Personally Known
0 Produced Identification 0 Produced Identification-
Notary Signature: 00946y Notary Signature:
- - - - - - - - - - - - -
UL MY
COAB IdmkS.&A-1-r-Aft-Ands lkft of Fin 1114 P,
F0- -1. '3=
0 OD343313
wow" - - -
A. L1JLL%4%&
4
Jeff Kottkarnp
Enviro=ental Protection Lt.Governor
& Marjory Stoneman Douglas Building
R
FLOWA 7 3900 Commonwealth Boulevard Michael W.Sole
Tallaltassee,Florida 32399-3000 Secretary
(Mail Station 300)
January 28,2008
Judith Jacobson
2359 Seminole Road
Atlantic Beach,Florida 32233
Dear Ms.Jacobson:
Field Permit Notice to Proceed Usued
Field Permit Number. 8023002-DU
Permittee Name: Judith Jacobson
Your request-for a permit pursuant to Section 161.053, Florida Statutes,for construction or other activities
seaward of the coastal construction control line,consisting of the construction of an approximate 145 square
foot fi-angible,open,elevated,detached wood deck seaward of the existing swimming pool,has been
approved by the Department. The permit and approved plans are enclosed. Please complete the applicant
information portion of the permit and return the white and pink pages to the letterhead address(add Mail
Station 300)as won as possible. nia-Ae--Q zfoz.�
The authorized work is strictly limited to that described on the permit and approved plans. Failure to comply
with the permit will result in issuance of a violation notice or order to cease and desist all activities authorized
by the permit. The Department may order illegal construction removed and legal remedies pursuant to
Chapter 161 and 775,Florida Statutes, including but not limited to the assessment of fines of up to$10,000 for
each day of violation.Any notice of violation will be mailed directly to the property owner.
If you have any questions pertaining to this permit,please contact me by mail at the letterhead address(add
Mail Station 300),by telephone at(850)921-7949,or by email to valerie.jones@dep.state.fl.us.
Sincerely,
0
Valerie Jones,Pdrmit Manager
CCCL,Bureau of Beaches and Coastal Systems
vj/
Enclosures
cc: Permit Information Center
Trey Hatch,Field Inspector
Atlantic Beach Building Official
"More Protection. Less Proces-
Printed an tacyded paW
3900 Commonweakth Wvd—MS 300 Pen"if Nuxiber.
Tallahassee,FL 323W3000
&ORI&A (850)488-7708 ' No.qfPages A fiached.
FIELD PERMIT PURSUANT TO SECTION 161.053 or 161.052,FLORIDA STATUrES
FINDINGS OF FACr AP41) CONCLUSIONS OF LAW: The mquest for a permit wu considered by the staff designee of the Department of
Envnwunmtd Protection wid found tD be in compliance,with the mquyernaits of Chapter 6211-33,Florida Admimsbahve Code(F-A-C.). Approval is
specirmany hmded to the activity in the stated locebon and by the pro)cd description,appnnvd plam;(if any),attached standard conditions,and any special
cmdifims gbacd below punguant to Panigraph 161.053(5�Florida Statuics. This permit may be suspended or rervoked in accordance with Section 62.
4.100,F�kC.
PROJECT'L43CATION:
FRojacr DESCRIPTION:
SPECIAL PERM11'CONDITIONS: This permit is valid only after&D- falerid,dslc�and local permits are obtained and does ad sivillmdes
contravention of kmw w"a mquirementi;or zoning or building -, 1 1 This permit and public natice;shall be pooled on the she nwdddy Mm
gisuance and shall ranam posted along with local appioval until the completion of any acbvity audiorized by dus permit Other special cooMm of ddl
-- mut include:
STANDAItD pzRNffr CONDrrIONS: The paminve oW comply with the sUachad duAsW field permit conditions.
AppLICANT INFORMATION: I hereby certify thal I on cithw. (I&)dw owner of*4 vA*d property gi (I b)I have the owner's conscid ID securt
dus permit on the ownces bawlt and that(2)1 shall obtais any r. 0 or permits which may be raquired by Weral,sixic,cm*,or municipal
lgw pnm to commaicernad of the,audiorked wor1c; (3)1 acknowladge dwA dic adhorized work is what I requeded;and(4)1 accept responisbility for
coniphance,with all permit conditions.
Applicanh Taisphont:140.
Applicant's Pyinted Nam A&bm
If applicant is an agent
�qfpnw�"Ov�"W � PVVP"ownff�r nZiew pvp"owwOs ukphmw ne
DEPARTMENT MAL ACTION AND FILING AND ACKNOWLEDGMENT: This field permit is approved an b"V of the Department of
,Rnv"0nmcnw prokefion by dw undersigned gaff designee,and filed on this dak�pursumit to 120.52,F.S.,with ft undamped dcsignbcd
ncouty Clerk,ixecipt of which is hmby acbmwiedged.
CkV* Primkd Nmw ofDgjiVwc0qw*CJw*
PUBLIC NOTICE is ON THE ILACK OF TMS PERMIT. EXPUtATION DATR-
,��ney pcmutB ismied pusuant to Sccfion 62B-33.014,F�A-C.,we valid for no nxxc thari ninely days and other field we vaW for so mom
dw 12 months. The staff designee may specify a shorter time limit.)
EMERGaXY PUtNT:0 YES UNO Appromd pillng 111111 11111001104L MMS Qgo
A"PUBLIC NOTICE CONSPICUOUSLY ON TM SITE
DEP foan 73-122(updated 01/06) ffdkCM-TaUahasaw0fflmJ [YeHowCopy-Appficad] ~Copy-S&qffDearw,'
01/24/08 11:29 FAX 904 292 0119 E G PONTROLS.INC Q002
APPROVED PLAN AS PERMITTED
BY BUREAU OF BEACHES
AND COASTAL SYSTEMS
FLORIDA DEPT Or-
ENVIRONMENTAL PROTECnON
wnjoRrm CONSnUCTION AND ANY OTHER AUTHOPIZE0
ACTI�,ATIES MUST CONAKYW-H ALL CONDITIONS OF THE
r$-R&ArT CONSTRUCTION AW AZTIVITIES ARE STRICTLY
L!OAITED TO T-iOSE BOTH SHOWN ON THE APPROVED PLANtc
AND LTSTFD iN THE PROJECT DESCRIPTION THIS PERMIll
IS ISSUED PURSUANT TO 04 161.FS.AND OTHER PERMITS
MAY BE-REQUIRED
13A
DATO PERMIT F40
90
C%41
va
62
LINA,NG AREA
45 sq ft
6vu, fw 4,6z��
I'c, 0A co-%46cJte-(k
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-TIJ V,
AUTHORIZED CONSTRUCTION AND ANY OTHER AUTHORrIED
ACTrATIES MUST COMMY W:-H ALL CONDITIONS OF THE
ri.R"AfT CQNSTRUCTK)N AND AZTIVITIES ARE STRfCTLY
L*AITED TO T-<VSE BOTH SHOWN ON THE APPROVED PLANS,
AND LISTFD iN THE PROJECT DESCRIPTION THIS PERMIT
IS ISSUED PURSUANT TO CH 161.FS.ANO OTHER PERMITS
MAY 8 RE(JUIRED
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FEELD PEPJVM CONDMONS
The following conditions shall apply to FIELD PERMITS(unless waived by DEP or modified by special permit
condition). In the event of a conflict between a field permit condition and a special permit condition,the special
condition shall prevail.
1) The permittee shall carry out the construction or activity for which the permit was granted in accordance with
the plans and specifications that were approved by DEP as part of the permit. Any deviation there from shall
be grounds for suspension of the work and revocation of the permit pursuant to Section 120.60(7),F.S.,and
may result in assessment of civil fines or issuance of an order to alter or remove the unauthorized structure,or
both.No other construction or activities shall be conducted.No modifications to project size, location,or
structural design are authorized.A copy of the permit shall be conspicuously displayed at the project site.
2) The permittee shall conduct the construction or activity authorized under the permit using extreme care to
prevent any adverse impacts to the beach and dune system,marine turtles and their nests and habitats,or
adjacent property and structures.
3) The permittee shall allow any duly authorized member of the staff to enter upon the premises associated with
the project authorized by the permit for the purpose of ascertaining compliance with the terms of the permit
and with the rules of DEP, until all construction or activities authorized or required in the permit have been
completed and the project accepted by DEP.
4) ne permittee shall hold and save the State of Florida, DEP, its officers and employees,harmless from any
damage(no matter how occasioned and no matter what the amount)to persons or property that might result
from the construction or activity authorized under the permit and from any and all claims and judgments
resulting from such damage.
5) The permittee shall allow DEP to use all submitted records,notes,monitoring data,and other information
relating to construction or any activity under the permit for any purpose it may deem necessary or convenient,
except where such use is otherwise specifically forbidden by law.
6) Construction traffic shall not operate and building materials shall not be stored on vegetated areas seaward of
the control line, unless specifically authorized by the permit. If(in the opinion of DEP staff)this requirement
is not being met,positive control measures shall be provided by the permittee at the direction of DEP staff.
Such measures may include temporary fencing,designated access roads,adjustment of construction sequence,
or other requirements.
7) The permittee shall not disturb existing beach and dune topography and vegetation except as expressly
authorized in the permit. Before the project is considered complete,any disturbed topography or vegetation
shall be restored (as prescribed in the permit)with suitable fill material or revegetated with appropriate beach
and dune vegetation. ist of sand which
8) The fill material shall be obtained from a source landward of the control line and shall cons
is similar to that already on the site in both grain size and coloration.This fill material shall be free of
construction debris,rocks,or other foreign matter.A sample of the sand shall be provided to the staff
representative of the Bureau of Beaches and Coastal Systems during the preconstruction conference.
9) If surplus sand fill results from any approved excavation seaward of the CCCI,such material shall be
distributed seaward of the CCCL on the site,as directed by DEP staff(unless otherwise specifically
authorized by the permit).
10) Any native salt-resistant vegetation destroyed during construction shall be replaced with plants of the same
species or,by authorization of DEP,with other native salt-resistant vegetation suitable for beach and dune
stabilization.Unless otherwise specifically authorized by the staff,all plants installed in beach and coastal
areas(whether to replace vegetation displaced,damaged,or destroyed during construction or otherwise)shall
be of species indigenous to Florida beaches and dunes(i.e.,sea oats, sea grape,saw palmetto,panic grass,salt
meadow hay cord grass, seashore salt grass,and railroad vine).
11) All topographic restoration and revegetation work is subject to approval and acceptance by DEP staff.
12) If not specifically authorized elsewhere in this permit, no operation,transportation,or storage of equipment or
materials is authorized seaward of the dune crest or rigid coastal structure during the marine turtle-nesting
season.The marine turtle-nesting season is May I through October 31 in all counties(except Brevard, Indian
River,St. Lucie,Martin,Palm Beach and Broward counties where marine turtle nesting occurs during the
period of March I through October 3 1).
13) If not specifically authorized elsewhere in this permit,no temporary lighting of the construction area is
authorized at any time during the marine turtle-nesting season and no additional permanent exterior lighting is
authorized.
14) This permit has been issued to a specified property owner and is not valid for any other person.
CITY OF ATLANTIC BEACH PERMIT
G DEPARTMENT APPLICATION #
BUIELDING / ZONIN
'00 Seminole Road
Atlantic Beach,Florida 32233
(904)247-�8000
(904)247-5845 Far,
vrww.coab.us
APPLICATION TRACKING FORM
REQUIRED DEPT:
PLANNING
BUILDING
Property Address., k9 zi z
I.— PUBLIC WORKS
0 Y N � PUBLIC UTILITIES
Applicant:
Y N FIRE DEPT.
Project: y N PUBLICSAFFIY
-APPROVAL
REQUIRED AGENCY: RECEIVED BY: INITIAL: DATE-
0 0
Z Lu
Y N D.E.P HUFSTETLER
< S.J.R.W.M. CARPER
C3 Y N
cc ui
ui Y N ARMY CORPS of ENG CARPER
HUFSTETLER
0 Y N HOTELS&RESAURANTS
APPLICATION STATUS
CIRCLE ONE: SITE BUILDING DA AP REV IEVVED BY: INITIAL: DATE:
[3 1 ST REV
4d-hmk.� A,4 Wl��
El 0=_
BUILDING
PUBLIGWORKS
PUBLIC UTILITIES
FIRE DEPT.
P UBLIC SAFETY
3RD RE\
PM-11 W�n fbiQ fnrm f"thp 11114iblino nnnqrtment nnee vnift have entered vour comments into the AS400.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233
NO.:(904)247-W5
OFFICE:(904)247-5826*FAX
-DEPT@COAB-US
BUILDING
DUVAL COUNTY
BUILDING PERMIT APPLICATION
VALUATION OF WORK
0 ADDRESS: ;1006) .0o
.�1.3 5-7 (�- 6.. FSTRUCTURE:
4.LE DESCRIPTION: 5.CLASS OF WORK: IDENTIAL
0 NEW BUILDING 0 DEMOLITION RES
[3 ADDITION (3 CONVERTING USE [I COMME CIAL
LOT-BLOCK- SUB DIVISION 0 ALTERATION 0 ACCESSORY BLDG.. 8.FIRE SP INKLE
7.DESCRIPTION OF WORK: [3 REPAIR E3 POOL PA 0 YE
0 MOVE ER 0
CONTRAG I UK: ARCHUECT I IENGINEER:
PROPERTY OVMER: 15.COMPANY NAME: 23.0 MPANY NAME:
9.NAME:
24.LICENSEE NAME:
17.STATE LICENSE NO.: rF ST DA LICENSE NO.:
10.ADDRESS:
18.ADDRESS: 26.ADDRESS:
2-
J-13S I AX NO.: 27.OFFICE PHONE: 28.FAX NO-:
11.OFFICE PHONE: 12.FAX No': 19.OFFICE PHONE: Zu.,
etc;%- t if) qi)4-2A2--6 1%q 21.CELL PHONE: 29.CE
13.CELL PHONE:
o4_400 -1.7-4s 22.EMAIL ADDRESS. 30.EMAIL DRESS:
14.EMAIL ADDRESS:
C-01sowl cz-vi-Irats-Com MORTGAGE LENDER:
FEE HOLDER: BONDING COMPANY:
jIF OTmER THM OWNER) 35.NAME:
33.NAME:
31.NAME:
32.ADDRESS: 34.ADDRESS: 36.AUL)KtZ:�:
a permit to do the work and installations as indicated. I cer* that no work or installation has
Application is hereby made to obtain rk will be performed to meet the standards of all laws regulating construction in this
commenced prior to the issuance of a permit and that all wo
jurisdiction. This permit becomes null and void if work is not commenced within six (6)months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for
Electrical Work,Plumbing,Signs,Wells,Pool.';,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc.
OWNEITS AFFIDAVIT-I car*that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning.I will not occupy or use the referenced building or any part therof,until all inspections are finaled and
prior to obtaining a certificate of Occupancy or completion issued by the building official,as required by law.
WARNING TO OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LLENNDUER 'OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
CONTRACTOR
AGENT (Quaff-Only)
(if Agent,Power of Attorney or Agency Letter Required)
'L Date:
-0 8_ Signed:
Signed: day of 2007 in the county of
Before me is ly-day of 2007 in the county of Before me this
Duval,State of Florida,has personally appeared Duval,State of Florida,has personally appeared
X, --4 e-1-4 1"--- - io,
herin by himself I herself and affirms that all statements and declarations are hefin by himself I herself and affirms that all statements and declarat ns are
true and accurate.
true and accurate. County Of
N t Public at Large,State of County of-Aa-11-4-i- Notary Public at Large,State of
0 Personally Known
t;PP--"-Ily Known 0 Produced Identification-
C3 Produced Identification- Notary Signature:
Nota
COAB
P
1 2 gap"
M- x
10
Jeff Kottkainp
Envirorumental Protection Lt.Governor
FLOR)Ai.7- �� Marjory Stoneman Douglas Building
3900 Commonwealth Boulevard Michael W. Sole
Tallahassee,Florida 32399-3000 Secretary
(Mail Station 300)
January 28,2008
judith Jacobson
2359 Seminole Road
Atlantic Beach,Florida 32233
Dear Ms. Jacobson:
Field Permit Notice to Proceed Issued
Field Permit Number: 8023002-DU
Permittee Name: Judith Jacobson
Your request for a permit pursuant to Section 161.053, Florida Statutes, for construction or other activities
seaward of the coastal construction control line, consisting of the construction of an approximate 145 square
foot frangible,open, elevated, detached wood deck seaward of the existing swimming pool,has been
approved by the Department. The permit and approved plans are enclosed. Please complete the applicant
information portion of the permit and return the white and pink pages to the letterhead address(add Mail
Station 300)as soon as possible. 'La:s
ma-t - oqoz-�
The authorized work is strictly limited to that described on the permit and approved plans. Failure to comply
with the permit will result in issuance of a violation notice or order to cease and desist all activities authorized
by the permit. The Department may order illegal construction removed and legal remedies pursuant to
Chapter 161 and 775, Florida Statutes, including but not limited to the assessment of fines of up to $10,000 for
each day of violation. Any notice of violation will be mailed directly to the property owner.
If you have any questions pertaining to this permit,please contact me by mail at the letterhead address(add
Mail Station 300), by telephone at(850)921-7849, or by email to valerie.i ones(2d dep.state.fl.Lis.
Sincerely,
1 N\
j iu-
Valerie Jones,Permit Manager
CCCL, Bureau of Beaches and Coastal Systems
vj/
Enclosures
cc: Permit Information Center
Trey Hatch, Field Inspector
Atlantic Beach Building Official
"More Protection. Less ProceS--
FWnted on recycled paoer
3900 Commonwealth Blvd-MS 300 perIMUNUMbAr.- -81 21-60
AROMPA Tallahassee,Fl,32399-3000 � 14�-
(850)488-7708 Na qfPqg=A&=hvd-
MMW PERMT PURSUAW TO SECTWN 161AS or IGIAMM,FLOWUM STATUTZS
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DEP form 73-122(Updawd 010) vh&Cq*.Tb&JmweQjIkqj j'yeffowCqpy-Appfi=dj pjukCciy,&WDm4vi�j
Charlie Crist
Governor
crnartMent of Jeff KottkarnP
Florida D%-I Lt.Governor
11tal protect,011 Michael w.Sole
Envir011me Ln Douglas Building
MarjorY StonemE 'alth Boulevard SecretarY
3900 Conulloilwe
Florida 32399-3000
A -rallahassee, Station 300)
11 FLO (mail
j 8,nuary 29,2008
Judith Jacobson
2359 Seminole poad 321Al
Atlantic Beach,Florida
Dear Ms- Jacobson'
Pernlit Notice to Proceed issued
Field 9023002-DU
Field Permit Number* Judith Jacobson
Permittee Name'.
77�L 053 Florida Statutes,for construction or other activities
,it pursuant to Section 161. n of an approximate 145 square
your request for a perm control line, consisting of the constructio imming pool has been
seaward of the coastal construction k seaward of the existing sw leie the applicant
foot frangibleg open,elevated�detached wood dec ved plans are enclosed. Please cornP ss(add Mail
The pen-nit and appr, pages to the letterhead addre
by the Department-
approved turn the white and pink
inforn.lat,on Portion of the permit and r
Station 3oo) as soon as possible. scribed on the permit and approved plans. Failure to COMP Y
strictly limited to that de notice or order to cease and desist all activities authorized
The authorized work is suance of a violation ed and legal remedies pursuant to
with the permit will result in is ay order illegal construction remov ssessment of fines of UP to$10,000 for
by the permit. The Department in s including but not limited to the a property owner.
Chapter 161 and 7759 Florida Statute , will be mailed directly to the
each day of violation. Any notice of violation ontact me by mail at the letterhead address(add
&&R.sta
ions pertaining to this permit,please c ones de tej1us
If you have any quest (850)921-7849,or by email to valeri
Mail station 300),by telephone at
Sincerely,
Va2lerie Jo:nes,P t Manager
CCCL,Bureau of Beaches and Coastal Systems
vj/
Enclosures
cc: Permit Information Center
Trey Hatch, Field Inspector
Atlantic Beach Building Official
"More Protec#on
,L OSS plOCO
Jug,,, RbI716ewfec
,CY
CITY OF ATLANTIC BEACH
800 SEARNOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
INSPECTION EMAIL REQUEST:
Building-depte
coab.us
Application Number . . . . . 08-00000164 Date 2/12/08
Property Address . . . . . . 2359 SEMINOLE RD
Application type description RESIDENTIAL ADDITION/ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2000
----------------------------------------------------------------------------
Application desc
deck
----------------------------------------------------------------------------
Owner Contractor
------------------------
------------------------
JACOBSON, SAMUEL S. OWNER
2359 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
--------------------- Structure Information 000 000 ----------------------
Construction Type . . . . . TYPE 5-A
Occupancy Type . . . . . . RESIDENTIAL
Flood Zone . . . . . . . . ZONE X
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . - 40 . 00 Plan Check Fee . 00
Permit Fee . . . . Valuation . . . . 2000
Issue Date . . . .
Expiration Date . . 8/10/08
----------------------------------------------------------------------------
Special Notes and Comments
SPECIAL PERMIT CONDITIONS EXIST PER THE DEP.
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 40 . 00 40 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 40 . 00 40 . 00 . 00 .00
pERWr,IS "PROVED ONLy IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
_x. -jL%-fjL&%.194,4, A-1%If_F%AL.JL"JLX%OXX%l
Jeff Kottkamp
Environmental Protection
Marjory Stoneman Douglas Building Lt Governor
hael W.Sole
F YA 3900 Commonwealth Boulevard Nlic
TalWhassee,Florida 32399-3000 Secretary
(Mail Station 300)
January 28,2008
Judith Jacobson
2359 Seminole Road
Atlantic Beach,Florida 32233
Dear Ms.Jacobson:
Field Permit Notice to Proceed Issued
Field Permit Number: 8023002-DU
Permittee Name: Judith Jacobson
Your request for a permit pursuant to Section 161.053,Florida Stawtes,for construction or other activities
seaward of the coastal construction control line,consisting of the construction of an approximate 145 square
foot fi-aigible,open,elevated,detached wood deck seaward of the existing swimming pool,has been
approved by the Department. The permit and approved plans are enclosed. Please complete the applicant
information portion of the permit and return the white and pink pages to the letterhead address(add Mail
Station 300)as won as possible. rvia_Ae=Q
The authorized work is strictly limited to that described on the permit and approved plans. Failure to comply
with the permit will result in issuance of a violation notice or order to cease and desist all activities authorized
by the permit The Department may order illegal construction removed and legal remedies pursuant to
Chapter 161 and 775,Florida Statutes,including but not limited to the assessment of'fines of up to$10,000 for
each day of violation.Any notice of violation will be mailed directly to the property lowner.
If you have any questions pertaining to this permit,please contact me by mail at the letterhead.address(add
Mail Station 300),by telephone at(850)921-7849,or by email to vaterie.iones it-ate-fLus-
Sincerely,
C=
C
P
Valerie Jones,Pdrmit Manager L16J
CCCL,Bureau of Beaches and Coastal Systems
16J6=
vi/
Enclosures
cc: Permit Information Center
Trey Hatch,Field Inspector
Atlantic Beach Building Official
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DEP form 73-122(Upda"01/05) jyeftwCojpy-Appfiw;4j
FILE COPY
01/24/08 11:29 FAX 904 292 0119 E G CONTROMINC Q002
APPROVED PLAN AS PFql0fTTE0
BY BUREAU OF BEACHES
AND COASTAL SYSTEMS
FLORIDA DEPT OF�
ENVIRONMENTAL PROTECTION
AtiTHoRrzED CONSTRUCTION AND ANY OTHER AUTHORrIED
ACTI,JITIES MUST Compty W.--M ALL CONDITIONS OF THE
r$-Rk4rT CONSTRUCTION AND AZTIVITIES ARE STRICTLY
L'�AITED TO T-iOSE BOTH SHOWN ONTHE APPROVED PLANS
AND USTFO iNTHE PROJECT DESCRIPTION THIS PERM(l
IS ISSUED PURSUANT TO CH 161,FS.AND OTHER PERMITS
MAY B"E(JUIRED
13'4 1 DAT0j PERMIT NO
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APPROVED PLAN AS PERMITTED
BY BUREAU OF BEACHES
AND COASTAL SYSTEMS
FLORIDA DEPT OF
ENVIRONMENTAL PROTECTION
AUTHORIZED CONSTRUCTION AND ANY OTHER AUTHOWED
ACTIVITIES MUST COMMV W,-H ALL CONDITIONS OF THE
rl.1141T CONSTRUCTIONAND AZTIVITIES ARE STRICTLY
L!�AITED TO T-iOSE BOTH SHOWN ON THE APPROVED PLANS
AND LISTFD iN THE PROJECT DESCRIPTION THIS PERMIT
IS ISSUED PURSUANT TO CH 161.FS.AND OTHER PERMITS
-- ---- AY BE REWIRED
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FIELD PERMIT CONDITIONS
The following conditions shall apply te- FIELD PERMITS(unless waived by DEP or modified by special permit
condition). In the event of a conflict between a field permit condition and a special permit condition,the special
condition shall prevail.
1) The permittee shall carry out the construction or activity for which the pen-nit was granted in accordance with
the plans and specifications that were approved by DEP as part of the permit. Any deviation there from shall
be grounds for suspension of the work and revocation of the permit pursuant to Section 120.60(7),F.S., and
may result in assessment of civil fines or issuance of an order to alter or remove the unauthorized structure,or
both.No other construction or activities shall be conducted.No modifications to project size, location,or
structural design are authorized.A copy of the permit shall be conspicuously displayed at the project site.
2) The permittee shall conduct the construction or activity authorized under the permit using extreme care to
prevent any adverse impacts to the beach and dune system,marine turtles and their nests and habitats, or
adjacent property and structures. enter upon the premises associated with
3) The permittee shall allow any duly authorized member of the staff to
the project authorized by the permit for the purpose of ascertaining compliance with the terms of the permit
and with the rules of DEP, until all construction or activities authorized or required in the permit have been
completed and the project accepted by DER
4) The permittee shall hold and save the State of Florida, DEP, its officers and employees, harinless from any
damage(no matter how occasioned and no matter what the amount)to persons or property that might result
from the construction or activity authorized under the permit and from any and all claims and judgments
resulting from such damage. monitoring data,and other information
5) The permittee shall allow DEP to use all submitted records, notes,
relating to construction or any activity under the permit for any purpose it may deern necessary or convenient,
except where such use is otherwise specifically forbidden by law. f
6) Construction traffic shall not operate and building materials shall not be stored onvegetated areas seaward o
the control line, unless specifically authorized by the permit. If(in the opinion of DEP staff)this requirement
is not being met, positive control measures shall be provided by the pennittee at the direction of DEP staff.
Such measures may include temporary fencing,designated access roads, adjustment of construction sequence3
or other requirements.
7) The permittee shall not disturb existing beach and dune topography and vegetation except as expressly
authorized in the permit. Before the project is considered complete, any disturbed topography or vegetation
shall be restored(as prescribed in the permit)with suitable fill material or revegetated with appropriate beach
and dune vegetation.
8) The fill material shall be obtained from a source landward of the control line and shall consist of sand which
is similar to that already on the site in both grain size and coloration.This fill material shall be free of
construction debris,rocks, or other foreign matter. A sample of the sand shall be provided to the staff
representative of the Bureau of Beaches and Coastal Systems during the preconstruotion conference.
9) If surplus sand fill results from any approved excavation seaward of the CCCL, such material shall be
distributed seaward of the CCCL on the site, as directed by DEP staff(unless otherimise specifically
authorized by the permit).
10) Any native salt-resistant vegetation destroyed during construction shall be replaced with plants of the same
species or,by authorization of DEP, with other native salt-resistant vegetation suitable for beach and dune
stabilization.Unless otherwise specifically authorized by the staff, all plants installed in beach and coastal
areas (whether to replace vegetation displaced, damaged, or destroyed during construction or otherwise)shall
be of species indigenous to Florida beaches and dunes(i.e., sea oats, sea grape, saw palmetto, panic grass, salt
meadow hay cord grass, seashore salt grass, and railroad vine).
11) All topographic restoration and revegetation work is subject to approval and acceptance by DEP staff.
12) If not specifically authorized elsewhere in this permit, no operation,transportation, or storage of equipment or
materials is authorized seaward of the dune crest or rigid coastal structure during the marine turtle-nesting
season. The marine turtle-nesting season is May I through October 31 in all counties(except Brevard, Indian
River, St. Lucie,Martin, Palm Beach and Broward counties where marine turtle nesting occurs during the
period of March I through October 3 1).
13) If not specifically authorized elsewhere in this permit, no temporary lighting of the construction area is
authorized at any time during the marine turtle-nesting season and no additional permanent exterior lighting is
authorized.
14) This permit has been issued to a specified property owner and is not valid for any other person.
FILE COPY