1720 PARK TERR E - GAZEBO PERMIT 'i, CITY OF ATLANTIC BEACH
A j 800 SEMINOLE ROAD
j= £.. ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
J;319�
ACCESSORY STRUCTURE NEW RES
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ACST-1878
Job Type: DETACHED ACCESSORY STRUCTURE NEW
Description: DETACHED 18' x 24' COVERED GAZEBO
Estimated Value: $6,000.00
Issue Date: 9/6/2016
Expiration Date: 3/5/2017
PROPERTY ADDRESS:
Address: 1720 E PARK TER
RE Number: 172020-0396
PROPERTY OWNER:
Name: FOSTER, MIKEL J & JOAN TRUST, *
Address: 1720 PARK TER
PERMIT INFORMATION: PUBLIC WORKS:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing
activities. Contact Public Works(247-5834) for Erosion and Sediment Control Inspection prior to start
of construction.
All runoff must remain on-site during construction.
Roll off container company must be on City approved list and container cannot be placed on City Right-
of-Way. (Approved: Advanced Disposal, Realco Recycling, Republic Services,Shapell's, Sunshine
Recycling and Waste Pro).
Full right-of-way restoration, including sod, is required.
FEES:
PLAN CHECK FEES $40.00
BUILDING PERMIT FEE $80.00
IMI`CpPtir)t'M[ti' 1N"N€FRDANCEU1Y1`"ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
if-------
Vii, CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
r
� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
r4J1319}
STATE DCA SURCHARGE $2.00
Total Payments: $124.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL (TI'Y OF ATLANTIC I3EACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
S,:L1J:,��, City of Atlantic Beach APPLICATION NUMBER
Js t•
t• Building Department (To be assigned by the Building Department.)
Y 800 Seminole Road (D—
Phone
Atlantic Beach, Florida 32233-5445 ( Iii !
Phone(904)247-5826 • Fax(904)247-5845
-(011 �r E-mail: building-dept@coab.us Date routed: 8 CO
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:
ri ZO 'PQK ( & . C_ D_•_ ment review re.uired �� o
Buil•.••
Applicant: (DUO KJ `_tanning &Zonin•
-e 'minis rator
Project: xec:Afeize_o(2.14- _rj.FZi:bli Works _-
Public a e y
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
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: roved. ['Denied.
(Circle one.) Comments:
BUILDINGiv
PLAN 1 &ZONINGReviewed by: Date: 2�1b
TREE ADMIN. Second Review: LApproved 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 05/14/09
/1"
rs�A'''` BUILDING PERMIT APPLICATION
JS V� FILE COPY
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
\
'''Z-4011i9%- Office:(904)247-5826 • Fax:(904)247-5845
L (o-ACST 1 873
Job Address: 17.2 0 P' r k 1& 4c.e s t- Permit Number:
Legal Description 3 y U:6-__01- ,5___. - SSl - VA/m///V4RE#
Valuation of Work(Replacement Cost$(.---C:,'Com'ileated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial �esidenti
521)
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes ® N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
beirei,J is x a ft ' Cove,-ed G 4z ebo
Florida Product Approval# 1 CD I4 Z \ 2()0'V for multiple products use product approval form
Property Owner Information t C��F roa vGL 1
Name: m ore ,A Td, /-----0S T to I' Address: / 70,Z 0 P/iii/f / 74-CE �-s�
City ))f04- h c !3c State FLZip 3.2.233 Phone 9c7 2L/9 4.7 .1.2'..i
E-Mail m /r4cL,e,1 , 6. b -//sotuht , /veer ii,,,er Soy 21i5/ swD
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required)
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.
Contractor Information: --
Name of Company: Qualifying a rent:
Address: City State Zip
Office Phone Job Site/Conta - 'umber
State Certification/Registration# E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Worker's Compensation
Exempt / Insurer / Lease Employees / Expiration Date
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
pnor 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(ti months, or if construction or work is suspended or abandoned for a
period ofsix(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 and Air Conditioners,etc.
Signature of Property Owner: lezige 9R _ Signature of Contractor:
Before e,� �,.., rwdb7
this 11 Day of .u? t Before me this Day o
Notary blio.!r•"w. . T , o 4.6.7 ( /d
Notary Public:
, :, ,tp,r,vi.t:.„04
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 type of work will be complied with whether specified herein'or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any other.fecderal, state, or local law regulating construction or the
performance of construction.
Rev. 3/14/16
(----
j
CITY OF ATLANTIC BEACH
0 WNER / BUILDER AFFIDAVIT FILE COPY
•{:,-,.50E.).).
I. 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 MUST
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.
17.2 D PA-r-K ! �-r-fl-c e 1-�4sF 90 V- 2q9-e.6.27
ADDRESS PHONE NUMBER
/1 I/le 4. Fd s r er'
PRINT NAME /
-X144 r r r_//6
SIGNATU-E ` I n DATE
Before me this 1"-Q day of \ rt C V E 'I 20.Vcin the county of
Duval,State of Florida,has personally ap eared herin by himself/herself and affirms that
all statements and declarations are true and accurate. ``
Notary Public at Large,State of _,County of lIJUck.1
Personally Known
❑Produced Identification- ",,,
.s,rpr auk, HEATHER N DUUGf..S
_'+° 1 `0 Notary Public -State of Flonda
.•• •, My Comm.Expires Nov 28.201
Notary Signature: 14 ,,,,E--�- Commission *FF 174584
°rr',t�"r,�,` Bonded through National Notary Assn
FJBLDG/Owner•BuilderAffadavit,REVISED:4/16/2009
s--i'j City of Atlantic Beach APPLICATION NUMBER
41 .. , Building Department (To be assigned by the Building Department.)
800 Seminole Road [ / — �aT;rAtlantic Beach, Florida 32233-5445 �Phone(904)247-5826 • Fax(904)247-fiIcIIdE
5 AUG //
��J i 9%• E-mail: building-dept@coab.us 8 z0t6 Date routed: a / t 8 1 1O
City web-site: http://www.coab.us
LY;
APPLICATION REVIEW AND TRACKING FORM
Property Address: PD_•,_ment review required Yes No
Applicant: (DUO t� `Buil•_••
_-
nning &Zonin•
-- -A .minis rator
Xd bli Works
Project: I�j �� CVG2C-� (.....,'
��-C..=
Public a e y
Fire Services
Review fee $ Dept Signature ,f`lA
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
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 Reviewed by: 2,76--1-/ )7X,v---- Date: W/ 8/16
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied.
p*Ai C WOR Comments:
,'UnLIVES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
ii.:Lyjy,, City of Atlantic Beach APPLICATION NUMBER
-J * � Building Department (To be assigned by the Building Department.)
s tla Seminolec Road b /' _ I , P78
I j,,� .r Atlantic Beach, Florida 32233-5445 <D Int
Phone(904)247-5826 • Fax(904)247-5845
"7_01110- E-mail: building-dept@coab.us Date routed: 8 1
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 17
D- •_ ment review required Yes No
ZO H-�.K � ��.. C -
Buil.
Applicant: OiA_D K.DER. `-tanning &Zonin. __-
• .minis rator
Project: x Zak C.-o' egi� 4� ( bliWorksl�
Public a e y
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
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:
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 05/14/09
oArv;y., TREE & VEGETATION AFFIDAVIT
,d_PP , City of Atlantic Beach
Department
800Seminole of CommunityRoadAtlantic DeveloBeach,FpmentL 32233
97 z5 Planning&Zoning Division
(P)904 247-5800 (F)904 247-5845 PERMIT#
SECTION I-APPLICANT INFORMATION r• Owner(s) r Legal Authorized Agent*
NAME OF APPLICANT `'7/4"e L Fos 72c-
NAME OF COMPANY
ADDRESS OF COMPANY 17 go 8,7,-lc [ere iee t 4. 6.
PHONE c2L67 7.21 CELL 707 58-.2.q EMAIL /Vie%Al!..'G/1plP ek6Z.4 , "'ct
Gtl 2'o4 d
CONTRACTOR CERTIFICATION NUMBER
ATLBCH BUSINESS TAX RECEIPT NUMBER
SECTION II-SITE INFORMATION
STREET ADDRESS OF PROPERTY /?2,O Pte,ir (�,.y. e fr..', il .6
If an address has not been assigned to this property,contact the AB Building Department at(904)247-5826 to request an address.
LEGAL DESCRIPTION &.-Lv1. At./it4ef /,v)+#ir Pig/'Ave 3c/ LY
LOT of BLOCK SUBDIVISION CV
REAL ESTATE NUMBER LOT OR PARCEL SIZE: SQ FT AC
RESIDENTIAL COMMERCIAL OTHER(SPECIFY)
I affirm that I have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation"of the Municipal Code of
1 Ordinances for the City of Atlantic Beach, FL and/or I have participated in a pre-application meeting with the Administrator of those
regulations. Subsequently,I affirm that no regulated trees and no regulated vegetation will be damaged,destroyed and/or removed
from the above-described or adjacent properties in conjunction with this project.
r
S ATURE OF OWNER
SIGNATURE OF OWNER /
Signed and sworn before me on this by of ,2O6 ap.y State of F l
6--- County of 1 J(7v0. c
Identification verified:
�� (— No
..O1�1�tiykti TONI GINDLESPERGER
4r, .,1 MY COMMISSION i FF 924951 • 1)45-1(.,-
; _ ,r,/ EXPIRES:October 6,2019
'•#.'11? '• Bonded ThruNotary PubficUnderwriters Notary Signature
REV-TVA-v10.1 2 My Commission expires:
stivi:,:,,, City of Atlantic Beach APPLICATION NUMBER
�, Building Department (To be assigned by the Building Department.)
• I 800 Seminole Road �/� T
•` • Atlantic Beach, Florida 32233-5445 LD" U�1e ( I
� / Phone(904)247-5826 • Fax(904)24RECE/VE
84AUG 18 2016
�,;2 0 E-mail: building-dept@coab.us Date routed: 8 1 1c7
City web-site: http://www.coab.us
BY: _.
APPLICATION REVIEW AND TRACKING FORM
Property Address: 17 iD Ppt-R_K ( (L, L D_•_ment review required Yes No
4 Buil...• )
Applicant: (DUO K `_'tanning &Zonin. _-
- .minis rator
Project: p)` X 2_`'/t t t �V�iZC� (� .,(� bli Works
Public a e y
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
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: MApproved. ['Denied. 6c$0.-,zz--/6
(Circle one.) Comments: -lee i
BUILDING
PLANNING & ZONING ( ZZI
Revi- ed by: Date: G
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
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MAP S.T`: WING SURVEY OF
All of Lot 29, as shown on e plat of SELVA MARINA UNIT NO. 8 as recorded in
Plot Book 34, Page 85 of t : Current Public Records of Duval County. Florida.
Certified To: J.. M. Foster
M. -1 J. Foster Trustees Of The And John M. FosterTrust, 50Z Interest
- — _.— - ---L. vers Title-insurance Co.
M: ill Lynch Credit Corp. -
A.:x Real Estate Information Services, LLP
. D. 'd S. Gamsey, Esquire
PARK
' N .�•'38'14" W, 110.00'(R)
Q 11% 0 "32'55" W, 109.94'(M)
FOUND Q I gel y ,'II '
1/2" IRON PIPE FOUND
NO ID
1/2" IRON PIPE
NO ID
.r
.O
N....—.•
y• � / 14.0'
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LOT 30 °; PARK
1 ST0I Y STUCCO RESIDENCE
co co
' w ADORE NUMBER 1720 0 I" p
Z AREA # 2737 SQUARE FEET Q
Z � �
12.0' POORCIRIED CONC. 0 Z
—di._ .D z Z
,— 17.1' 25.2' eD KO28.6 v
I _v
— 30' BRL •gl v t4' CONC. MN_
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of
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FOUND `'
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NO ID ri
M r
BCH S 05 06'45" E, 49.92' O I"j FOUND
PER PLAT TO PRM +�� comas •••6ammo - 1/2 IRON PIPE
CURVE DATA No ro
L=110.00 (scSANITARY MH
R=4804.65
L'. 1.18'42"
BRG = S 04'09'55"W
CH = 110.00'
PARK TERRACE EAST
60' R/W
•
VALID WITHOUT THE SIGNATURE AND THE ORIGNAL RA/SED SEAL OF A FL LICENSED SURVEYOR AND MAPPER.
BEARINGs ARE BASED ON THE WESTERLY R/Vi UNE OF PARK TERRACE. 04+09.55' W. TS LEGEND DATE OCT 23, 2001
THIS IS A BOUNDARY SURVEY, 0 DENOTES REFEREN1.0l.12NT SCALE 1. = 30'
ELEVATIONS SHOWN THUS (15.0) REFER TO UNITED STATES COASTAL AND 110 SURVEY x—x DENa7Es refer
)K1014, NATIONAL GEODETIC VERTICAL OF 1929, (N.G.VA. OF 1929). JOB NO. 7274
Q
9Y GRAPHIC PLOTTING ONLY. THE PROPERTY SNOW HEREON UES WITHIN !ONES X (UNSHADED) Smai)1/1' ,. F BOOKS) 179
ILS SHOWN ON THE FEDERAL EMERGENCY MANAGEMENT AGENCY(F.E.M.A.). NATIONAL FLOOD • MOTES IRON RPE FOUND PACE(S) 48
NSURANCE PROGRAM, FLOOD INSURANCE RATE MAP (F.I.R.M.) COMMUNITY PANEL NUMBER: •
TN'.oma)
120075 - 000+ 0 MAP REVISED DATE: 4/r7/I989 CD►NUTERKAREN/ORAYANGS/7274.0wo
.INLESS GTxERWISE NOTED, ANY PORTION OF THE PARCEL THAT MAY BE Min AS Ilk-RANDS )< TE:5 o+ms an FLE NAME Dfoltn by 101
1Y STATE IEREFROMOISR OTT THETHRESPONSBLITY of THE UNDERSIGNED.NED A� ANY LI UTM RESULTING A & J LAND SURVEYORS, INC.