340 CAMELIA SFR VOID 8/19/15 City of Atlantic Beach
1 Building Department �^�, APPLICATION NUMBER
P 800 Seminole Road (To be assigned by the Building Department.)
Atlantic Beach, Florida 32233-54 "5 JV
Phone(904) 247-5826 • Fax(9 247-5845 2
E-mail: building-dept@coab.us
City web-site: http://www.coab.us Date routed: �p 2
tLs—
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3 ��M l A S7,;Fire
WServices
nt review required Yes No
E0N
Applicant: �Ag`C �� �N—� Zoning
istrator
Project: gyp) E cJ F�CI_ s
es
ty
s
Review fee $ 90 Dept Signature �`
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
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. []Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING ) `,,��— /Ly
Reviewed by: Date:
TREE ADMIN.
Second Review: []Approved as revised. []Denied.
BIIC WQRKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. @Denied.
Comments:
viewed by: Date:
Revised 07/27/10
CITY OF ATLANTIC BEACH
�s a Building Department
800 Seminole Road
J ;r Atlantic Beach,Florida 32233
(904)247-5800
PLAN REVIEW COMMENTS
Permit Application #J5
Property Address: 3y0 CQ rYl e / T OA
Applicant: L-eon C 1)?a r
Project: -e w
This permit application has been:
0, Approved
Reviewed and the following items need attention:
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Please re-submit your application when these items have been completed.
Reviewed By: Date: 9•-G /'S--
SIM
ZONING REVIEW COMMENTS
City of Atlantic Beach
jBuilding and Zoning Department
f:.
800 Seminole Road Atlantic Beach, Florida 32233-5445
Phone: (904) 270-1605 Fax: (904) 247-5845 Email: dreeves@coab.us
Date: 8/5/15
Permit: 15-SFR-1484 Applicant: Leon C Martin Inc
Review: 2nd Address: 7221 Knoll Dr S, Jacksonville, FL 32221
Site Address: 340 Camelia St Phone: (904) 396-4955
RE#: 170876-0050 Email: N/A
Correction Comments
1. Wetlands Buffer: Section 24-272(c)(2) requires a minimum 25 foot undisturbed upland buffer from
jurisdictional wetlands. The wetlands survey and documentation provided by O.0 Reedy established a
jurisdictional wetlands line on and near the property. When a 25 foot upland buffer was applied,
several portions of the structure crossed into the buffer. Please revise plans so that no portion crosses
into the 25 foot upland buffer.
2. Site Plan: Please show the 25 foot upland buffer on the site plan.
3. Tree Removal: Please submit a Tree Removal Permit Application if any trees are to be removed. If no
trees are to be removed, then please fill out an Affidavit of No Tree Removal. Both forms are available
on the city website under "Planning and Zoning" and at City Hall. Also please be aware that codes
have recently changed. If you are unsure about how the new codes effect your project, please submit a
Tree Removal Permit and staff can then determine if it is necessary.
Derek W. Reeves
Planner
dreeves@coab.us
2
ZONING REVIEW COMMENTS
} City of Atlantic Beach
j Building and Zoning Department
800 Seminole Road Atlantic Beach, Florida 32233-5445
oil I Phone: (904) 270-1605 Fax: (904) 247-5845 Email: dreeves@coab.us
Date: 7/1/15
Permit: 15-SFR-1484 Applicant: Leon C Martin Inc
Review: 1 st Address: 7221 Knoll Dr S, Jacksonville, FL 32221
Site Address: 340 Camelia St Phone: (904) 396-4955
RE#: 170876-0050 Email: N/A
9r 13 ts Inc LO GO 1 .C�
Correction Comments
1. Wetlands: Wetlands are identified on or near the property in the City's Wetlands Map found in the
Comprehensive plan. Section 24-272(a) requires applicants wishing to develop lands in these areas to provide
an environmental assessment. If wetlands are found to be present on or near the property, a 25 foot upland
buffer shall be shown.The 25 foot buffer is to remain undisturbed by all current and future development.
2. Setbacks: The site plan does not show the distance between the structure and the rear property line.
Please revise the site plan to show this measurement.
3. Tree Removal: Please submit a Tree Removal Permit Application if any trees are to be removed. If no
trees are to be removed, then please fill out an Affidavit of No Tree Removal. Both forms are available
on the city website under "Planning and Zoning" and at City Hall. Also please be aware that codes
have recently changed. If you are unsure about how the new codes effect your project, please submit a
Tree Removal Permit and staff can then determine if it is necessary.
Derek W. Reeves
Zoning Technician
dreeves@coab.us
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 -
�� Office (904) 247-5826 Fax (904) 247-5845 _
Job Address: ��_Cj✓1?P��1 ci 51voe Permit Number:' 3
Legal Description �' LI l !(Parcel# = ' —
S�
P'loor Area o q. t.
Valuation of Work$J�l Proposed Work heated/cooled� — non-hea>ied
Class of Work(circle one): TO Addition Alteration Repair Move Demolition pooUspa window/door
Use of existing/proposed structure(s) (circle one): Commercial esidentiaPo
If an existing structure,is a fire sprinkler system installed? (Circle one): es N/A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: l� �1►�0��� M 1 �� lt�P,�
Property Owner Information: �3 110 I
Name: L�- Address: - -. EI'!n i�F
City State_V-ip 3 _Phone
E-Mail or Fax# (Optional) 0 C
Contractor Information: 904 3 g ��
Company Name: d i n'1In Qualifying Agent: L e6k, 64
Address: Ci Stat1 t Zi
Office Phone U - - (15-45> Job Site/Contact Number.t 113 �U eWl Fax# tj(Q(�e�. j7Gt(p Z
State Certification/Registration# S
Architect Name& Phone#
Engineer's Name&Phone# Tt to i - 15 2- CD_6 q
Fee Simple Title Holder Name and Address 'I
Bonding Company Name and Address
ki 4-
Mortgage Lender Name and Address h a
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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, P/umbing,Signs, Wells, Pools, urnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc.
WARNING 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
1 hereb 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
type of work will be co_plied with whether s ect ied herein or not. The granting of a permit does not presume to gyve authority to violate or cancel the
provisions of any other er 1,state, or loc w regulating c s uction or the performance of construction.
12
Signature of Owner Signature ature of Contracto
+ ) l
Print Name .. ...1..1.�.. ...........l .lr 1. Print Name Leov,......._..).......I� t! 1 .... .................................
4
Sworn to and subscribed before me Sworn to and subscribed before me 20 I
thi 0 20 this � ' Day o
Notary P li Notary Public . �� J NE CLARK
SPRY•P.�B���, JENNIFER LYNNE CLARK + * MY COMMISSION#FF 072755
MY COMMISSION#FF 072755 r EXPIRES:Nove 2iP§A01.26.10
* * EXPIRES:November 24,2017 �?c�F , Bonded Thru Budget Notary Services
r"".F 11-eP Bonded Thru Budget Notary Services
i�_'iu'iCity of Atlantic Beach
vs Building Department APPLICATION NUMBER
'i 800 Seminole Road [[Date
e assigned by the Building Department.)
' Atlantic Beach, Florida 32233-5445 5 /{
Phone(904) 247-5826 • Fax(904)247-5845 — ~ ��8""t
R191, E-mail: building-dept@coab.us
City web-site: http://www.coab.us routed: t�/Z
APPLICATION REVIEW AND TRACKING FORM
340
Property Address: 0P1V m t A S7, De artment review required Yes No
Buildin
Applicant: EOjV (.�g-r l � anning &Zoning
Project:
is rator
�A) E$[ /UCG u is Wor s
is tilities
u is a ety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
t Verified By Date
Florida Dept. of Environmental Protection of Permi
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. ADenied.
(Circle one.) Comments: j L� 444f. t
BUILDING
PLANNING &ZONING XA_�"Reviewed by: (/ Date: 1 ,f
TREE ADMIN. `
Second Review: []Approved as revised. XDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: ,O� ///� Date: �s
FIRE SERVICES Third Review: ❑Approved as revised. []Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
u muo-t N is r hkCV11 I AFFLIC;ATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: G���I CI Permit Number:
Legal Description LI l�� S / IK li'arcel#: 1 ly "2 Cie - CXj S
Floor Area o Sq.P't. q: t
Valuation of Work$ Proposed Work heated/cooled 11PAC! non-heated/cook _f y(_ Z
Class of Work(circle one): bo Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial 'esidenti;1 �
If an existing structure,is a fire sprinkler system installed? (Circle one): es N /A
Florida Product Approval #
For multiple products use product approva orm n
Describe in detail the type of work to be performed: � _-&^j _ALAAat b'�A c
Property Owner Information: /3
Name: W- Address: I I �_ _ _ -J£'ry i�F
City State=V_ip 3zz1z1 Phone �} - S S
E-Mail or Fax#(Optional) _ V G
Contractor Information:
Company Name: +� l r�'1 Qualifying Agent: L i
Address: Ci Stat/ Zip 262-22-1
Office Phone Ub - 5S Job Site/Contact Number �3 Zr'/Q(p��j Fax#�dp 4 �5(p(q;
State Certification/Registration# v'
Architect Name& Phone#
Engineer's Name&Phone# G2y 1i _ i G,A C)rvx O - If 25 2 - (_D 6r)q
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address h if a
4pplication is hereby made to obtain a permit to do the work and installations as indicated. I certifi,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
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
vork is commenced. I understand that separate permits Hurst be securedfor Electrical Work, Plumbing,Signs, Wells, Pools, urnaees, Boilers, Heaters,
Tanks and Air Conditioners,etc.
WARNING 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 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
,ape of work will be co_plied with whether s eci red herein or not. The granting of a permit does not presume to give authority to violate or cancel the
rovisrons of any other oder 1,state, or loc w regulating c s. uction or the performance of construction. !
,ignature of Owner , Signature of Contracto
P
r) + + 1n
().L
rint Name �7..�4...1..�.0... ........... ..1'. .1.......................:........................... Print Name �J..✓ ........ .,......_ ......k...1 ............_h.................................
worn to and subscribed before me Sworn to and subscribed before me
�i 0 20 this ` Da�C o 20
'W(A
otary P li RY, Notary Public-; JNWWt5RNE CLARK
"
JENNIFER LYNNE CLARK b1Y COMMISSION FF 072?5E
* ;<,t < * ti11'COMMISSION#FF 072755 EXPIRES:Nove ,V>[S9d701.26.10
'= c�
rg4:1' r EXPIRES:November 24,2017 ,P Banded Thru Budget Notary Sen ices
"'roc F�oP Bonded Thru Budget Notary Services
CITE' OF ATL.&NTIC BEACH
PUBLIC UTILITIES
1200 Sandpiper Lane
ATLANTIC BEACH,FL 32233
(904)270-2535 or(904)247-5874
NEW WATER/SEWER TAP REQUEST
Date: 6-2245'- Project Address: Co4mEfi�g- 5f
No. of Units: Commercial Residential ✓ Multi-Family
New Water Tap(s)&Meter(s) Meter Size(s)_3/.q „
New Irrigation Meter Upgrade Existing Meter from to (size)
New Reclaimed Water Meter Size New Connection to City Sewer
Name:
Applicant Address:
City: State: Zip
Phone Number: Cell Number:
Email Address Fax:
Signature:
(Applicant)
CITY STAFF USE ONLY
Application# 1464-
Water
484-
Water System Development Charge $ /, /y0, 00
Sewer System Development Charge $ OS-D. 6
Water Meter Only $
Reclaimed Meter Only $
Water Meter Tap $ 900,00 (notes)
Sewer Tap $
Cross Connection $ S ,pig
Other $
TOTAL $ . co
APPROVED: Kavle Moore,PE kZ
(Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE
APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED