225 11th St 2013 driveway CITY OF ATLANTIC BEA -
�
s) 800 SEMINOLE ROAD
►� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003753 Date 12/27/13
Property Address . . . . . . 225 11TH ST
Application type description RIGHT-OF-WAY PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
paver driveway and walkway
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Owner Contractor
-
------------------------
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HARRISON GRADY TRAVIS & KARI L OWNER
225 11TH ST
ATLANTIC BEACH FL 322335755
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Permit . . . . . . DRIVEWAY PERMIT
Additional desc . .
Permit Fee . . . 35 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 6/25/14
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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 .
Pavers must be installed over crushed rock per ICPI
Standards provided to homeowner.
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
ENG REV BLDG MOD OR ROW 25 . 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 54 . 00 54 . 00 . 00 . 00
Grand Total 89 . 00 89 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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R.O.W. Permit Attachment of for
R.O.W. Permit# issued , 20 Atlantic Beach, FL 32233
Owner's Name: GR- C.-t
Property Address: I--:?—S \Av"+ S'r
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 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).
This work is generally described as: y4,-&W W Fooe_VA,"
Patii�!7RS
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 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 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 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 insure 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. I
DATED and SIGNED this day of Did , 20 /
By
Property Owne
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this 2(0 day of 0 201,3 personally appeared before me, a Notary
Public in and for said County and State, , 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
exec to me freely vo rily and for the uses and purposes therein mentioned.
i � a
otary P lic in f said C my nd State rs.'
:•••y�, SHIRLEY L GRAHAM
MY COMMISSION#DD 957760
aE`(PIRES:February 14,2014
'�„o..f;,�r Bonded Thru Nota
CITY OF ATLANTIC BEACH, FLORIDA, a �� Notary Public underwriters
municipal corporation:
Approve
V
Ricky L. Ca er,Public Works'Director
For Permits where city sidewalk is impacted,
City Manager approval required:
IUb_1
Jim Hanson, City Manager
Page 2 of 2
CITY OF ATLANTIC BEACH /� I'
' CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND MEI`
v 800 Seminole Road _ 47g6�00
�;ill Atlantic Beach,Florida 32233-5445 eFax 904-24 - 4�013
PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH A ICATION.
\� _2� ` NOV 26
Date 2
PER
Job Address ISSUED Y THE CITY
Permitee: ���� � a Z Scl� Telephone# cw�
Permittee Address:
Requesting Permission to Construct:
Location: (Reference to Cross-Street) 0f EftV4
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:
Jacksonville Electric Authority Yes( ) No ( ) Date:
Bell South Telephone Company Yes( ) No ( ). Date
Ferrell Gas Yes ( ) No ( ) Date.
Comcast Yes( ) No ( ) Date:
2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation,
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
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 Florida Department of Transportation Standards and be
performed under the supervision of (Contractor's Project
Superintendent) 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 property shall be restored to its original condition as far as practical, in keeping with city specifications
and the manner satisfactory to the city. .
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 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 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 permittee must review the permit with the Director of
Public Works to make sure no changes have occurred in the area that would affect the permitted construction.
8. 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 interestin 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-a'nd
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.
OWNER
Signed Date:
Before me this day of in the County of Duval,
State Of Florida personally appgamOA
Nota lic Lar e, to _f FI _ida, unty of Duval
My .
ex re . y
:*i,c�MMiS90N#DD 957160
.FM!lFES:February 14,?.014
onded
BThru Nnrnry Public Underwriters
CITY OF ATLANTIC BEACH
(OWNER / BUILDER AFFIDAVIT
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION
CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA 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 OWNER OF YOUR PROPERTY.TO ACT AS
YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST
SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE—OR
TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING
MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT 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 CONTRACTOR, YOUR CONSTRUCTION NILIST
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 COUNTY OR MUNICIPAL LICENSING
ORDINANCES.
II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO
OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY
EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY
CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPETENCY' OR THE FLORIDA "CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(247-5826) IF IN DOUBT.
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.
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ADDRESS PHONE NUMBER
Gc �� ��zz�sa�
PRINT NAME
t�
SIGNATURE DATE
Before me thi day of V 20/]the
]the county of
Duval,State of Flon a,has personally appeared herin by himself/herself an�that
all statements and declarations are tru accurate.
Notary Public at Large,State of L County of
kersonally Known
Produced Identification
Notary Sig ure: (..�
F:BLDG/Owner-Builder Affadavit;REVISED: 4/16/2009 cc (/
Grady Harrison
225 11th street
Atlantic Beach, FI, 32233
904-860-4396
Subj: Permit application for new driveway and walkway
The attached forms (construction permit, owner affidavit, lot sketch, most recent survey & area
calculations) are for a permit application for a new driveway and walkway. The intent is to
install the new drive and walkway initially (phase 1) and then replace the existing driveway and
walk ways with the same,{pavers (phase 2). The second phase will be completed immediately
following the new drive and walkway. I am applying for this as a homeowner, but intend for
the work to be performed.by a licensed contractor. I am in the process of getting quotes
currently. Depending on the cost estimate of phase 2, we may delay that installation.
I had contacted Sunshine811 about marking utility line locations, but they had told me that
they will only come out once the job has a start date. I am to call them 3 — 5 days prior to job
start. Utility access to my house is on the NE corner of the lot and is away from the new
construction. Water is the only utility that is underground and is marked on the sketch. Any
other unknown utilities will be marked by Sunshine811.
Calculations for impervious surfaces have been completed and are attached. Additions to the
slab area include a fireplace (FP), a/c foundation, hot tub (HT) and pond. The total impervious
area comes to 48% of the lot.
Please let me know if any additional information is necessary to be submitted with this
application and how fees are to be paid.
Grady Harrison
MAP SHOWING BOUNDARY SURVEY OF
LOT I BLOCK p0 OF44 ACCORDING
pTO�THE PLAT OF
A 11pLANn ACH
AS RECORDED IN PLAT BOOK 5, PAGE(S) 64 OF THE
CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO, GEADY TRAVIS HARK SON. RARI L. HARRISON.
WATSON S OSBORNE TITLE SERVICES. INC..
SIF.GART TITLE OF JACKSONVILLE, INC.
AND FIRST ALLIANCE BANK.
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�J1J City of Atlantic Beach APPLICATION NUMBER
s�
(To be assigned by the Building Department.)
Building Department
800 Seminole Road
} Atlantic Beach, Florida 32233-5445
Phone (904)247-5826 • Fax (904)247-5845
E-mail: building
-dept@coab.us j Date routed:-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �i �T Department review require Yes No
p Building
/�
Applicant: U It) Planning &Zoning
Tr inistrator
Project: Public Works
is Utilities
V f V1� Q. Safety
1 Fire re Services
Review fee $ _ Dept Signature
Other Agency Review or Permit Required Review or Receipt Dateof Permit Verified S
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers I
Division of Hotels and Restaurants i
Division of Alcoholic Beverages and Tobacco
Other:
I
APPLICATION STATUS
Reviewing Department First Review: Approved. ❑
Denid
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
7
RK Comments:
LIC UTILITIES
PUBLIC SAFETY Reviewed by. Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
iy11Jj� City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone (904)247-5826 • Fax(904)247-5845
r
E-mail: building D
D;,1} ate routed: Z
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ?i 2 �! ry ST Department review required Yes No
/� `• t p Building
U
Applicant: 10 Planning &Zoning
Tr inistrator .
Project: Public Works
is Utilities
V� �� ublic Safety
Fire Services
Review fee
Dept Signature
$ p g
Other Agency Review or Permit Required Review or Receipt Dateof Permit Verified B
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: Date:
TREE ADMIN. Second Review: Approved as revised. []Denied.
Comments: - ✓j�
PUBLIC WORKS
PUBLIC UTILITIES Y-0
Reviewed by: Dat
PUBLIC SAFETYe: !�
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14109