1691 ATLANTIC BEACH DR - NEW HOME PERMIT CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
SINGLE FAMILY DWELLING NEW
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-SFR-2472
Job Type: SINGLE FAMILY RESIDENCE
Description: NEW HOME/DRIVEWAY
Estimated Value: $394.724.00
Issue Date: 11/6/2015
Expiration Date: 5/4/2016
PROPERTY ADDRESS:
Address: 1691 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: TOLL BROS.,INC
Address: 250 GIBRALTAR RD STEVEN R MERTEN
Phone: - -
PERMIT INFORMATION:
FEES:
ENG REV RESIDENTIAL BLD $100.00
UTIL REV RESIDENTIAL BLDG $50.00
STATE DBPR SURCHARGE $20.46
SEWER SDC-SYSTEM DEV CHG $4,050.00
WATER CONNECT/TAP & METER $370.00
WATER CROSS CONNECTION $50.00
WATER SDC-SYSTEM DEV CHG $1,140.00
IMIBILDINGIPEWITMEEN ACCORDANCE$11,1364q7CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
0- , �s CITY OF ATLANTIC BEACH
l 800 SEMINOLE ROAD
+� -~/"� ATLANTIC BEACH,FL 32233
/ INSPECTION PHONE LINE 247-5814
\JJ3I9`'
PLAN CHECK FEES $682.09
Total Payments: $7,826.72
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
R.O.W. Permit Attachment of for
R.O.W. Permit# issued , 2015 Atlantic Beach, FL 32233
Owner's Name: Toll FL VI, LP
Property Address: 1691 Atlantic Beach Drive
Atlantic Beach, FL 32233
Subdivision: Atlantic Beach Country Club
Lot#/Block#: 16
R.E. #: 169505-1375
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this /Z,$day of
gd,pi ,20 /f,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
1
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 SIGNE this 12th day of October , 2015.
By:
Stev erten, Toll FL VI, LP.
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this 12th day of October , 2015,personally appeared before me, a Notary Public in and for said
County and State, St. Johns, Florida ,the property owner of 1691 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 p •, es therein mentioned.
/
•.�'pY PV ••'
;=o A e<,,„ MELISSA LIEBERMAN
MY COMMISSION #FF055605
-'<aF
'49.1 EXPIRES September 18.2017
Not• Pus n for said County and State
(407)390.0153 FlerldallotaryService.com
CITY i F ATLANTIC BEACH, FLORIDA, a
municipal corporation:
Approved:
Doug L;, on, Public W2rks Director
For Permits where city sidewalk is impacted,
City Manager approval required:
Nelson Van Liere, City Manager
Page 2 of 2
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BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach,FL 32233
Office (904)247-5826 Fax (904)247-5845
Job Address: 1691 Atlantic Beach Drive; Atlantic Beach, FL 32233 Permit Number:
Legal Description Lot 16 Atlantic Beach Country Club Unit 2 Parcel 67-132-08-2S-29E.165
Floor Area of Sqq.Ft. Sq.Ft
Valuation of Work$ 364,724 Proposed Work heated/cooled 3,067 non-heated/cooled 653
Class of Work(circle one): Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structures) (circle one): Commercial Residentia
installed? i
If an existing structure,is a fire sprinkler system nstalled. (Circle one):: No 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: arosers antollbrothers.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
ssuancelof a permit and that all work permit
ill be performed to meet the installations as indicated. 1
of all laws regulating constru construction in this jurisdiction�((Thiis permitibecomes
null and
work void is commencedt commenced 1 understandtthat separate permitsimust be secured for Electrical Work, Plumbing,(Signs period Furnaces,Boilers,
NsA\ CITY OF ATLANTIC BEACH
_,. � PUBLIC UTILITIES
1260 Sandpiper Lane
s3���' ATLANTIC BEACH,FL 32233
(904) 270-2535 or (904) 247-574
1 EW%W WATER/SEWER TAP REQUEST
Date: /0 -?t) -I ( Project Address: /6 9/ 4rG,4/0TZC Wei/ p':
No. of Units: Commercial Residential t/ Multi-Family
New Water Tap(s)&Meter(s) Meter Size(s)L
New Irrigation Meter V Upgrade Existing Meter from to (size)
Ir
New Reclaimed Water Meter Size `{ New Connection to City Sewer t/
Name:
Applicant Address:
City: State: Zip
Phone Number: Cell Number:
Email Address Fax:
Signature:
(Applicant)
CITY STAFF USE ONLY
Application# /5- S/ -
Water System Development Charge $ 4 /4/0, CX)
Sewer System Development Charge $ /O fO, t)C)
Water Meter Only
Reclaimed Meter Only
Water Meter Tap $
Sewer Tap $ (notes)
Cross Connection $ cra- GYM /
Other $
TOTAL $ Co lta o t)
APPROVED: Kayle Moore,PE
(Deputy PW Director or Authorized Signature) ALL TAP REQUEST MUST BE
APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED
�;,s„%vi,j,, City of Atlantic Beach
�,• / ,� Building Department = - -. APPLICATION NUMBER
`�� 800 Seminole Road �' 1 (To be assigned by the Building Department.)
-•.., } 7�
�'` '' Atlantic Beach, Florida 32233-5445 Q D
Phone(904)247-5826 Fax(904) .47-5845CT A 9��,�
..Q
.Ent ck, E-mail: building-dept @coab.us Date routed: / /9
City web-site: http://www.coab.us -
APPLICATION REVIEW AND R A CKING FORM
Property Address: /� 91
77Q�G 4 ,4 C II - - - . 'Rent review required Yes No
q
Applicant: 7;7/ d-ye) . Planning &Zoning
/�//0 thmL /dr,.,,a,7 _Project: i�• • .s
4 •• • i ies —
" bI'c-Safet(
Fire Services
Review fee $ 'O Dept Signature w\___
Other Agency Review or Permit Required Review or Receipt
of Perm_it Verified By Date
Florida Dept. of Environmental Prote_ction
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: —
APPLIC ATION STATUS P _
_Reviewing Department First Review: Approved. ❑Denied
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: '4A__---Y1i (o /-/ /1 -
Date:
TREE ADMIN. --- -- — —Second Review: nApproved as revised. ❑Denied.
��'LIC WOR' S Comments:
iii
•UBLIC UTILITIES
._ .. _- •
PUBLIC SAFETY Reviewed by:
_ Date:
FIRE SERVICES Third Review: nApproved as revised. nDenied.
Comments:
__ _ Reviewed by: Date:
Revised 07/27/10
i
rs---: ;;,, City of Atlantic Beach ;,_ ,:
,.` Building Department APPLICATION NUMBER
tx1 800 Seminole Road (To be assigned by the Building Department.)
Atlantic Beach, Florida 32233-5445 ' ---f�"/�Q _ �V 72_.Phone(904)247-5826 • Fax(904) 7,-5845 7 a0.5
j`u;t-' E-mail: building-dept @coab.us f _
City web-site: http://www.coab.us - Date routed: /=
APPLICATION �`\
REVIEW AND T - ACKING FORM
Property Address: /o 9/ 77& ------
6 C I _,ar`t..ent review required Yes q s No
— -/ � 4'0 4 Applicant: �lj .Planning &Zoning
Project: h ) / 4�p b• IN, .s �/V
4 • 1 ies
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: J I Approved.
(Circle one.) C nDenied.
Comments: / ,/
BUILDING ` ie I �alrttyly i
PLANNING &ZONING
Reviewed fC by: C ` Date: v t��r"
TREE ADMIN. — -- 2
Second Review: nApproved as revised. Denied.
(15rJBLIC WORKS) Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:
Date:
FIRE SERVICES Third Review: nApproved as revised.
[Denied.
Comments:
Reviewed by: Date:
-
Revised 07!27/10 — —--
01- City of Atlantic Beach APPLICATION NUMBER
.45 • Building Department (To be assigned by the Building Department.)
,`'`,;' 800 Seminole Road /5 i f/e _ � 7Z
A Ir•? Atlantic Beach, Florida 32233-5445 f / /�
Phone(904)247-5826 • Fax(904)247-5845
` /9 /
o;t �. E-mail: building-dept @coab.us Date routed: ! i
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: / 9/ ,,'1772/774C pie • ' . . . ent review required irg No
Applicant: 77i d-yQ di Planning &Zoning
Project: /W& )')')L /dr).KW/9/ ;Pus
4-"..-71. .WM119P-1111111111111.M
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
Florida Dept. of Environmental Protection of Permit Verified B
y---
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:
APPL TION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING-&ZONING Reviewed by: / ` Date: � 1` 31 c
TREE ADMIN. Second Review: ❑Approved as revised. ❑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
rs=:tii. ,, City of Atlantic Beach
(....._
! Building Department APPLICATION NUMBER
`i� 800 Seminole Road (To be assigned by the Building Department.)
`r Atlantic Beach, Florida 32233-5445 Ai- 2f, - f T 72
Phone(904)247-5826 • Fax(904)247-5845 0,5-•!moo;; yr E-mail: building-dept @coab.us Date routed: / a
i City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /o 9/ 172Q/774 c 4967 ,art •ent review required Yes No
Applicant: 7;7/ Q s . Planning
._.::.,&Zoning
.ce: ..Pro ect: Vf b �m� •
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
ction
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 _ 1
Reviewing Department First Review: ]Approved. nDenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING //
Reviewed by:/ --�i�s.'��' ---- Date: L p ig
------ ---TREE ADMIN.
Second Review: (Approved as revised. (Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. nDenied.
Comments:
Reviewed by: Date:
Revised 07/27/10
Pe 57-7)R
NOTICE OF COMMENCEMVi LINT
State of:`FLORIDA Tax Folio No. 169505-1375
County of: DUVAL t
u
To Whom It May Concern: r�`•
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 16 Atlantic Beach Country Club Unit 2, 67-132 08-2S-29E.165
Address of property being improved: 1691 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:
Contractor: TOLL BROS.,INC.
Address: 160 CAPE MAY AVE.PONTE VEDRA,FL 32081
Telephone No: 904-217-0739 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: I
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 /
Signed: Date: i'T I�S
day of
Before me th• 1 lD ip the County of Duval,State
S
Doc#2015190036,OR BK 17273 Page 822, Of Florida,has personally appeared
Number Pages:1 Notary Public at Large,State f Florida,County of Duval.
Recorded 08/18/2015 at 03:29 PM, l':'Iy commission expires: Lj' 'ii -7
Ronnie Fussell CLERK CIRCUIT COURT DUVAL F/ersonally Known: v-e ,
COUNTY or
RECORDING$10.00 Produced Identification: , 1
op;33
:oa,►pr %•;� CYNTHIA KUOLAR I
3: \ 'c Notary Public-State of Florida
My Comm.Expires Feb 5,2017
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