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1696 ATLANTIC BEACH DR - NEW HOME PERMIT . i+ , yr �� ri t`` CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD j-y 4 ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 '-tc111�? SINGLE FAMILY DWELLING NEW MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-SFR-1901 Job Type: SINGLE FAMILY RESIDENCE Description: NEW HOME AND DRIVEWAY Estimated Value: $348,732.00 Issue Date: 8/28/2015 Expiration Date: 2/24/2016 PROPERTY ADDRESS: Address: 1696 ATLANTIC BEACH DR RE Number: None GENERAL CONTRACTOR INFORMATION: Name: TOLL BROS.,INC- Address: 250 GIBRALTAR RD STEVEN R MERTEN Phone: - - PERMIT INFORMATION: PUBLIC WORKS: UTIL'•TY DEPT.: Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact Public Works (247-5 •34) for Erosion and Sediment Control Inspection prior to start of construction. All silt must remain on-site during construction. Roll off Container Company must be on City approves list and container cannot be placed on City Right-of-Way. (Approved: Advanced Disposal, Realco, Republic Services, Shappel's and Waste Pro.) Full right-of-way restoration, including sod, is required. Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be overlaid 10 feet in each direction from the center of the cut. Repair must be shown on the plans. H--- OF;ATTIC BEACH-ORDI RIDA BUILDING CODES. 0 S.=Ly �� + '' s. .V`S� CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD J r, X ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 J,il9f' 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. FEES: -------- -- ----- ------ STATE DCA SURCHARGE $18.39 SEWER SDC-SYSTEM DEV CHG $4,050.00 STATE DBPR SURCHARGE $18.39 WATER CONNECT/TAP & METER $370.00 WATER CROSS CONNECTION $50.00 WATER SDC-SYSTEM DEV CHG $1,140.00 BUILDING PERMIT FEE $1,226.20 ENG REV RESIDENTIAL BLD $100.00 PLAN CHECK FEES $613.10 UTIL REV RESIDENTIAL BLDG $50.00 Total Payments: $7,636.08 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. s A CITY OF ATLANTIC BEACH : - PUBLIC UTILITIES 1200 Sandpiper Lane ����� : ATLANTIC BEACH,FL 32233 (904)270-2535 or(904) 247-5874 NEW WATER/SEWER TAP REQUEST Date: 8-/O-/5- Project Address: 169 1p ,7/i IL ,&-- w DK- No. of Units: Commercial Residential ✓ Multi-Family New Water Tap(s) &Meter(s) Meter Size(s) 3/./ New Irrigation Meter �'. - Upgrade Existing Meter from to (size) ,' ✓ New Reclaimed Water Meter Size 31q 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#!S —SFR - /90/ Water System Development Charge $ /, /HO. CAD Sewer System Development Charge $ • , DO Water Meter Only $ /A S d Reclaimed Meter Only $ igc; DO Water Meter Tap $ (notes) Sewer Tap $ Cross Connection $ , 00 Other $ TOTAL LS, 61/0. 00 APPROVED: Kavle Moore,PE —. (Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED ..-ii:;,,,,,, ..°f f s -(w`r gftk. City of Atlantic Beach �-w .�- t� .�, Building Department V D APPLICATION NUMBER '�; '. 800 Seminole Road A I1 (To be assigned by the Buildin De artment.) _ , a Atlantic Beach, Florida 3223 5445 Z�iS �- i'Building /9a Phone(904)247-5826 - Fa 1(904)247-5845 :!..9,;��� E-mail: building-dept @coab.us d City web-site: http://www.coab.us �'�'� Date routed: r APPLICATION REVIEW AND TRACKING FORM I Property Address: I ' ---r I, , /IC Department review required Yes No Idin. J6 /1 Applicant: S z. nrn. &Zorn 'minis ra or r"Project: ,Vf& /1/7,42)fD,,,,,„/„.,,,), ubli c Works i% n:ii. = uuua:� Review fee $ 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 1 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. (Circle one.) ['Denied. (Ci ) Comments: ��'� L� BUILDING JGe OpG'I' 61N �f� PLANNING &ZONING C �- Reviewed by: Date: a�3�S� TREE ADMIN. Second Review: ❑Approved as revised. I Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. Comments: Reviewed by: Date: Revised 07/27/10 • R.O.W. Permit Attachment of for R.O.W. Permit# issued , 2015 Atlantic Beach, FL 32233 Owner's Name: Toll FL VI, LP Property Address: 1696 Atlantic Beach Drive Atlantic Beach, FL 32233 Subdivision: Atlantic Beach Country Club Lot#/Block#: 82 R.E. #: 169505-1705 REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE EN ROACHMENT PERMIT, issued on this /3�'day of ,20 1 S ,by Atlantic Beach, Florida, a municipal corporation organized and existing under the laws of the State of Florida,hereinafter referred to as "CITY"and Toll FL VI, LP 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: Pavers in the Right of Way for the driveway. 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: 160 Cape May Ave. Ponte Vedra, FL 32081. 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 �. Y g 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 1of2 I 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 inure 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. DATED and SIGNED this tf71 day of ,446 3 r 2015. By: Stev erten, Toll FL VI, LP. (to be signed in presence of the Notary) STATE OF FLORIDA COUNTY OF DUVAL On this 24th day of July , 2015, personally appeared before me, a Notary Public in and for said County and State, St. Johns, Florida ., the property owner of 1696 Atlantic Beach Drive, Atlantic Beach, Florida, known to me to be tie person(s) described in and who executed the foregoing instrument; who acknowledged to me that he or she executed the same freely and voluntarily and for the uses and purposes therein mention-•. - , _ _ _ _ _ _ _ _ _ _ • =?o <<., CYNTHIA KUGLAR / _, s Notary Public-State of Florida i I It,� ��� My Comm.Expires Feb 5,2017 0 Not Public in for said Co 4 and State I %'� F '•, Commission x EE 870496 CITY OF ATLANTIC BEACH, FLORIDA, a municipal corporation: Appro Dour/ Prks lic Director , on, For Permits where city sidewalk is impacted, City Manager approval required: Nelson Van Liere, City Manager Page 2 of 2 70.Z•Z V --I/Ark/0! y7 x Ufa -fraci-Mat /9 kb., i% hz ? xi ld' a�97 la lora /ektia te ad, 276, 4g( / 3( 6 Pifre 1��� � 'f7bl �"Y� wv/ ��r-xy iy BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach,FL 32233 Office (904)247-5826 Fax (904)247-5845 Job Address: 1696 Atlantic Beach Drive:Atlantic Beach, FL 32233 Permit Number: Legal Description Lot 82 Atlantic Beach Country Club Unit 2 67-132-08-2S-29E.166 Parcel Floor Area of Sq.Ft. Sq.Ft Valuation of Work$ 348,732 Proposed Work heated/cooled 3,032 non-heated/cooled 915 Class of Work(circle one): 4100 Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial Residential installed?an existing structure, is a fire sprinkler system nstalled? (Circle one): o N/A Florida Product Approval# See attached For multiple products use product approval form Describe in detail the type of work to be performed:New Residential Construction Property Owner information: Name: TOLL FL VI LIMITED PARTNERSHIP Address: 160 Cape May Avenue City Ponte Vedra State FL Zip 32081 Phone 904 217-0739 E-Mail or Fax#(Optional)arogers @tollbrothers.com Contractor Information: CONTRACTOR EMAIL ADDRESS: arogers(atollbrothers.com Company Name: Toll Bros.,Inc. Qualifying Agent: Steven R. Merten Address: 160 Cape May Avenue City Ponte Vedra State FL Zip 32081 Office Phone 904 217-0739 Job Site/Contact Number 904 386-6472 Fax# State Certification/Registration#CGC 1510225 Architect Name&Phone# Engineer's Name&Phone# 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 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 pme after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, Furnaces, 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. I hereby certify that I have read and examined this ap lication and know the same to be true and correct. All provisions of laws and ordinances governing this rovissions of work any other federal,state,or local law regulating construction or the perf�orman a of constructionesume to give authority to violate or cancel the Signature of Contractor Si Signature of Owner � . Print Name Steven R.Merten,Division Sr.Vice President Print Name Steven R.Merten Before me Before me this 4 Day of Jul r / 2015 24 Da € Jul 2015 1 • +' Notary ' blic 4 Nota ublic Revised 01.26.10 IV,,`aY,,"'•,, CYNTHIA KUGLAF3 Notary Public-State of Florida t ,a�"�,"4, CYNTHIA KUGLAR a►f` ui'My Comm.Expires Feb 5,2017 � Notary Public-State of Florida•+. a Commission t EE 870498 ;,' My Comm.Expires Feb 5,2017 4 '•,,',,,,,,, r' Commission•EE 870496 1 f =is-,,), City of Atlantic Beach - 406' 'yf1J r ' `3 ;),,7;,; �` APPLICATION NUMBER Building Department . cf., > 800 Seminole Road / (To be assigned by the Building Department) Phone Beach, Florida • Fax 32233-5445) (r / B Phone(904)247-5826 • Fax(904)247-5845 -=:-.. /9O/ '�:��.,;'� E-mail: building-dept©coab.us City web-site: http://www.coab.us Date routed: 1J r APPLICATION REVIEW AND TRACKING FORM •k"' Property Address: ---i-^ /t�i Department review required Yes No Applicant: 6 II $ •• . Win. - Project: A/là) #0426 t�viam ree .minis ra or Mill Fire Services == Review fee $ 53 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 IMMIIIMIIIIIIMMIll Army Corps of Engineers Division of Hotels and Restaurants 11.......11111M1 Division of Alcoholic Beverages and Tobacco Other: IIIIIIIIIIIIMIIMMIIIIIIIIIMI APPLIC = ON STATUS Reviewing Department First Review: A •pproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed by: �_` ir />� TREE ADMIN. Date: ' Second Review: [Approved as revised. I 'Denied. ,I...,* C WOR C.mments: ■ ( a_ eL UTILITIES r i PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: [Approved as revised. ❑Denied. Comments: Reviewed by: Date: used 07/27/10 ■ ,.--:.i,,,, City of Atlantic Beach APPLICATION NUMBER . •;•`ti Building Department (To be assigned by the Building Department.) ' ',. •I 800 Seminole Road /— 1 / O "'�. Atlantic Beach, Florida 32233-5445 9 Phone(904)247-5826 • Fax(904)247-5845 '•�?;,;ii - E-mail: building-dept @coab.us Date routed: �d �6°. City web-site: http://www.coab.us . APPLICATION REVIEW AND TRACKING FORM Property Address: & 9c 17210 Lr 4/0,_Department review required Ye No �/6 /1' !ding_ Applicant: 4—rd S nin &Zon Project: A/f&) 4 Dr/Vf WM -ublic Works ra or T. u Fire Services Review fee $ 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: I Zproved. ❑Denied. • (Circle one.) Comments: :UILDING PLANNING &ZONING .-‘ ,,. Reviewed by: Date: -, J 1 TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: QApproved as revised. ['Denied. Comments: Reviewed by: Date: used 07/27/10 �; City of Atlantic Beach Building Department APPLICATION NUMBER ,.*:Y..,,r . 800 Seminole Road (To be assigned by the Building Department) ''''•) : Atlantic Beach, Florida 32233-5445 / (�� i' /BO t' 1~ 7 Phone(904)247-5826 • Fax(904)247-5845 ''.._./..,;.7i;;; E-mail: building-dept @coab.us City web-site: http://www.coab.us Date routed: if r APPLICATION REVIEW AND TRACKING FORM Property Address: & �/ �. "0'72,1475k AFC Department review required Yes No /64' Idin. - Applicant: id s -------- — r' _�nm. &Zon Project: 4ffj �/n f, `��/��y ree �;minis ra or =M. �____ _ _ ublic Works _ Fire Services _- Review fee $ 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 millinia St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: I — APPLICATION STATUS Reviewing Department First Review: ,Approved. (Circle one.) C ❑Denied. Comments: BUILDING PLANNING&ZONING Reviewed by: TREE ADMIN. Date: Second Review: ❑Approved as revised. ['Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. ['Denied. Comments: Reviewed by: Date: used 07/27/10 =_' ���1 CITE :r A'T'LANTIC BEACH g, 800 SKI' ROAD_ ,,- r P ; x ,, ATLANTIC BEACH,FL 32233 ‘'"a: :': (904)247.5800 spit--41E,3,3)-3W IS Iqoi Revision Request Sheet Date: e`I of ,15 Received by:___-_-_ _Resubmitted: Permit Number: I JO - ttfi \4 --t Clearance Sheet Number: t� /� Original Plans Examiner:_ 7 Project Name:_ Project Address: l tp CRP iH anti c b& r,Ir) Dr i vy Aj1 Qnti t, BeaC h , FL 3223.. Contractor: Contact Name: Ash let,' ROCrs Contact Phone Number:(CI 04)2l l-D-13 el Contact Fax Number: Revision/Plan Check/Permit Fee(s)Due:$ @ Description of Proposed Revision to Existing Permit: Pending Hold: Structural: Subryilli 1• new Floor -eleva•h by pia v,s w inn .1(16-9 V t_ • - G a.• %IA * • .A 4 Mw 4 ' '411114C— •O in b A_ • Si l Plumbing: GUI°Mtrted -Prone -fin tc oar-. Received erngil om 1 -1--Vi< Mechanical: — --- I • E4C� . Electrical: _ lit 211812- — _._.. IM -__ �-X15-_ I Miss.: - Additional Increase in Building Value:$ — _ Additional Squ. . Clearance Sheet/Site Plan Revised: __._....___ Environmental Health Approval: By signing below,I .Mt..m�� AShle RCJ€XT affirm that the above revision is inclusive of the proposed chance :IMO;2\ A _ I Ici 1 5 Signature linin :CtorA:1:1,t(loPntractor must sign iiiucreaseinvaluation) Date Office Use Only Date: if/2 ,g Approved: /.% _ Rejected: Notified by: Plan Review Comments: 2 � Plans Examiner Date Created 08ro5/01010 `doll Architecture MEMO -_- - moll Architecture MEMO TO: Stacia Moore Atlantic Beach Legacy 160 Cape May Avenue Ponte Vedra,Florida 32081 CC: Ashley Rodgers FROM: Shannon VanCleave,AIA Toll Brothers, Inc. DATE: August 17,2015 RE: Atlantic Beach Legacy—Lot 82 Franklin/Coastal Architectural Plan Addition/Revision On the above referenced lot, this letter shall be used to revise or clarify the following condition(s): 1. Added overall building height dimension; clouded and tagged on Sheet A5.82. If you have any questions regarding this letter feel free to contact me at Toll Architecture(407)-248- 5800. Sincerely, Shannon VanCleave,AIA AR97080 FLORIDA DIVISION 2966 Commerce Park Drive Suite 100 • Orlando,FL 32819 ■ (407)248-5800 • FAX:(407)248-5899 PHILADELPHIA•ORLANDO is DALLAS ■ SEATTLE A Toll`Brothers COMPANY Toll Architecture MEMO TO: Stacia Moore Atlantic Beach Legacy 160 Cape May Avenue Ponte Vedra,Florida 32081 6' CC: Ashley Rodgers FROM: Shannon VanCleave, AIA i,, , AUG 2 0 2015 Toll Brothers,Inc. U U V DATE: August 17,2015 -��A ► RE: Atlantic Beach Legacy—Lot 82 Franklin/Coastal Architectural Plan Addition/Revision On the above referenced lot,this letter shall be used to revise or clarify the following condition(s): 1. Added overall building height dimension; clouded and tagged on Sheet A5.82. If you have any questions regarding this letter feel free to contact me at Toll Architecture(407)-248- 5800. Sincerely, Shannon VanCleave,AIA AR97080 FLORIDA DIVISION 2966 Commerce Park Drive Suite 100 ■ Orlando,FL 32819 • (407)248-5800 ■ FAX:(407)248-5899 PHILADELPHIA• ORLANDO • DALLAS ■ SEATTLE A Toll`Brothers COMPANY Page 1 of 1 OFFICE COPY To11 Architecture LETTER OF TRANSMITTAL FOR PERMIT SET ORDER# 110332 SHIP TO: Stacia Moore FROM: Shannon VanCleave Toll Architecture COMMUNITY: Atlantic Beach CC 55's-Legacy- 3708 PHONE: (407) 248-5800 ADDRESS: 160 Cape May Ave. FAX: (407) 248-5899 Ponte Vedra, Florida 32081 MODEL: Franklin - 376 STUDIO LEADER: Shannon VanCleave Lot#(s): 0082 DATE: 06/10/2015 1 1 WE ARE SENDING YOU: • Checklist • Energy Calcs-REScheck(s) • Foundation Elevation Roof Plan (Attached Buildings) Energy Calcs-Manual J(s)via email • Lot Specific Permit Set(s) • Buyer Set(s) • Municipality Permit Set(s) • Letter(s) • Truss Profiles • Other Remarks: Toll Architecture has reviewed this package for accuracy and completeness. The checklist documents the current scope of permitting requirements and drawing revisions for your community. Please review the sealed permit plans for conformance with the checklist. For any changes or revisions to the checklist, please fax a marked up copy to the Studio Leader listed above. If for any reason the plans are not acceptable for submittal at this time, please contact the Studio Leader listed above. Orlando Office 2966 Commerce Park Drive, STE 100 ■Orlando, FL 32819■(407)248-5800■ FAX:(407) 248-5899 PHILADELPHIA■ DALLAS•ORLANDO A`Toll`Brothers COMPANY https://archonline.tollbrothersinc.com/archonline/app/letterOfTransmittal?execution=e4s 1 6/10/2015 es, BUILDING PERMIT APPLICATION OFFICE COPY CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: 1696 Atlantic Beach Drive., Atlantic Beach, FL 32233 Permit Number: /S- SFR--/9d/ Legal Description Lot 82 Atlantic Beach Country Club Unit 2 67-132-08-2S-29E.166 Parcel Floor Area of Sq.Ft. Sq.Ft Valuation of Work$ 348,732 Proposed Work heated/cooled 3,032 non-heated/cooled 915 Class of Work(circle one): 4210 Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial Residential installed?an existing structure,is a tire sprinkler system nstalled? (Circle one): o N /A Florida Product Approval # See attached For multiple products use product approval form Describe in detail the type of work to be performed: New Residential Construction Property Owner Information: Name: TOLL FL VI LIMITED PARTNERSHIP Address: 160 Cape May Avenue City Ponte Vedra State FL Zip 32081 Phone 904 217-0739 E-Mail or Fax# (Optional)arogers @tollbrothers.com Contractor Information: CONTRACTOR EMAIL ADDRESS: arogers(atollbrothers.com Company Name: Toll Bros., Inc. Qualifying Agent: Steven R. Merten Address: 160 Cape May Avenue City Ponte Vedra State FL Zip 32081 Office Phone 904 217-0739 Job Site/Contact Number 904 386-6472 Fax# State Certification/Registration#CGC 1510225 Architect Name& Phone# Engineer's Name & Phone# 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 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. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, 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 MEN OMERECORDING YOUR NOTICE OF I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this provisions of work will any other federal,state, or whether law regulating construction or the performac of permit does o presume to give authority to violate or cancel the Signature of Owner Signature of Contractor Print Name Steven R. Merten, Division Sr. Vice President Print Name Steven R. Merten Before me Before me this 24 Day of . Jul 2015 this 24 Da € Jul 2015 J....2A Pri .ddeLii Notary blic 4 Notary ublic NIP CYNTHIA y11Q��a Revised 01.26.10 1etst Public-state of Plaids ( I r1'0:1�" ''�. CYNTMUI KUGLAFi My Comm.ExpkeE Fab S,2017 fr. Notary Public-state o1 Florida Commission#EE S70ds8- � My Comm.Expires Feb 5,2017 ,'•�1„11 1, ''0„o,�,1, Commission#EE 870496 DO NOT WRITE BELOW - OFFICE USE ONLY Applicable Codes: 2010 FLORIDA BUILDING CODE Review Result (circle one): Approved Disapproved Approved w/ Conditions Review Initials/Date: 779- /off y1/S" Development Size Habitable Space 303,1 S: Non-Habitable 9/.5- 3.,P% Impervious area Miscellaneous Information Occupancy Group Q- 3 Type of Construction _ Number of Stories .2 Zoning District fILGC Max. Occupancy Load Fire Sprinklers Required Flood Zone 4/f' Conditions/Comments: OFFICE COPY R.O.W. Permit Attachment of for R.O.W. Permit# issued ,2015 Atlantic Beach, FL 32233 Owner's Name: Toll FL VI, LP Property Address: 1696 Atlantic Beach Drive Atlantic Beach, FL 32233 Subdivision: Atlantic Beach Country Club Lot#/Block#: 82 R.E. #: 169505-1705 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 Toll FL VI, LP 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: Pavers in the Right of Way for the driveway., 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: 160 Cape May Ave. Ponte Vedra,FL 32081. 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 OFFICE COPY 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 inure 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. DATED and SIGNED this day of , 2015. By: Stew erten,Toll FL VI, LP. (to be signed in presence of the Notary) STATE OF FLORIDA COUNTY OF DUVAL On this 24th day of July , 2015, personally appeared before me, a Notary Public in and for said County and State, St. Johns, Florida ., the property owner of 1696 Atlantic Beach Drive, 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 executed the same freely and voluntarily and for the uses and purposes therein mention-s. _ juvb4A, / ,-o�:"Y °B'- CYNTHIA KU6lAR ' °' Notary Public-State of Florida ws �` o, My Comm.Expires Feb 5,2017 Not Public in for said Co it and State 4 ••.,t-,;*.• Commission# EE 870496 CITY OF ATLANTIC BEACH,FLORIDA, a municipal corporation: Approved: Doug Layton, Public Works Director For Permits where city sidewalk is impacted, City Manager approval required: Nelson Van Liere, City Manager Page2of2 i n, 6 P-Prmy -1- 15- SF- g- 19o/ NOTICE OF COMMENCENtraNT OFFICE COPY State of: FLORIDA Tax Folio No. 169505-1705 County of: DUVAL • To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal Description of property being improved: Lot 82 Atlantic Beach Country Club Unit 2,67-132 08-2S-29E.166 Address of property being improved: 1696 ATLANTIC BEACH DRIVE,ATLANTIC BEACH.FL 32233 General description of improvements: NEW HOME CONSTRUCTION , Owner:TOLL FL VI LIMITED PARTNERSHIP Address: 250 GIBRALTAR RD. HORSHAM,PA 19044 Owner's interest in site of the improvement: FEE SIMPLE Fee Simple Titleholder(if other than owner): Name: 4A/ Contractor: TOLL BROS.,INC. Address: 160 CAPE MAY AVE.PONTE VEDRA,FL 32081 . P Telephone No: 904-217-3852 Fax No: 904-460-2683 Surety(if any) Address: Amount of Bond$ Telephone No: Fax No: Name and address of any person making a loan for the construction of the improvements Name: Address: Phone No: Fax No: ' Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may be served: Name: STEVE MERTEN • Address: 160 CAPE MAY AVE.PONTE VEDRA,FL 32081 ' Telephone No: 904-217-3852 Fax No: 904-460-2683 In addition to himself, owner designates the following person to receive 'a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option) Name: Address: Telephone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): 06/30/17 / THIS SPACE FOR RECORDER'S USE ONLY OWNER j Signed: Date: !�/�P/.S/ 6 Before me th'. .2r day of J UAL, in the County of Duval,State Doc#2015146982,OR oK 17214 Page 959, 9 Of Florida,has personally appeared Si PALO VIAP.✓�E'l, Number Pages:l Notary Public at Large,State of Florida,� County of Duval. Recorded Fussell ssell CL 15 at 1 RC8 IT My commission expires q11?5\\1 Connie Fussell CLERK CIRCUIT COURT DUVAL Personally Known: or RECORDING$10.00 Produced Identi COUNTY ;.t..:"e,'' MELISSA LIEBERMAN I Identification: :e ' € MY COMMISSION#FF055605 Li 1 72,A••""-------* 9.OF FL °i EXPIRES September 18.2017 1407)350-0153 FloridallotaryService.com l