1804 ATLANTIC BEACH DR - PERMIT (2) i--
,- r\,y\;, S, CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
j10 / 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: 16-SFR-2033
Job Type: SINGLE FAMILY RESIDENCE
Description: NEW SINGLE FAMILY RESIDENCE
Estimated Value: $450,000.00
Issue Date: 9/30/2016
Expiration Date: 3/29/2017
PROPERTY ADDRESS:
Address: 1804 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: RIVERSIDE HOMES OF N FL
, CBC1254135
Address: 414 OLD HARD RD STE 502 MATTHEW ROBERTS
Phone: - -
PERMIT INFORMATION:
FEES:
ENG REV RESIDENTIAL BLD $100.00
PLAN CHECK FEES $765.00
UTIL REV RESIDENTIAL BLDG $50.00
BUILDING PERMIT FEE $1,530.00
STATE DCA SURCHARGE $22.95
SEWER SDC-SYSTEM DEV $4,050.00
CHG�/ Bpi {�(,�/�R(jE $22 9
A10111%DAPItIt()� IUC)N'L1' IN r ARDANCE I7 H LI. CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
• , CITY OF ATLANTIC BEACH
A
og. 800 SEMINOLE ROAD
- • ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
�J131�?
WATER CONNECT/TAP & $370.00
METER
WATER CROSS CONNECTION $50.00
WATER SDC—SYSTEM DEV $1,140.00
CHG
Total Payments: $8,100.90
PERM'''. IS APPROVED ONLY IN ACCORDANCE WITH ALL (Try OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
.11 r, City of Atlantic Beach APPLICATION NUMBER
c, .-frz, o Building Department li - '4 y vE.,; (To be assigned by the Building Department.)
800 Seminole Road o`
Atlantic Beach, Florida 32233-5445
K\,.,.
Phone(904)247-5826 • Fax(904)248sEI , 1 1016
�or y E-mail: building-dept@coab.us Date routed: di L I_ I
City web-site: http://www.coab.us
BY:
APPLICATION REVIEW AND TRACKING FORM
D2
Property Address: I 0504__A'rt_440T i(' _ __ "H Department review required Yes No
II
uildin
Applicant: k ( Vc--g_st oc arming&Zonings
ree Administrator
Project: /U G l� S E R ublic Wor
blic Utilitie
' Public Safety
Fire Services
Review fee $ cb Dept Signature 'vv\
11
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: /44' �' Date: cdi If(C
TREE ADMIN. Second Review:
['Approved as revised. ❑Denied.
11 f4C11ALOyez.S.24t,nments:
PU IC UTILITIES
git
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
•Sy1,�Jjr . City of Atlantic Beach APPLICATION NUMBER
JS� , " Building Department (To be assigned by the Building Department)
: j& t 800 Seminole Road I J C F2 _ JJ
2
Atlantic Beach, Florida 32233-5445
Phone(904) 247-5826 • Fax(904)247-5845 j
J:3 re E-mail: building-dept@coab.us Date routed: • L L
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
►� 2
Property Address: t aoY Department review required Yes No
uildin•..
Applicant: R 1 V Z�S(>�C _' anning&Zoning
ree Administrator
Project: ND& E K ublic orks
blic Utilities
Public Safety _
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: AlApproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING ��t.si,��/C/�L_�ate: 7,4 �
Reviewed by: �c7' ((
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
E
Eivie
S,....,7 City of Atlantic Beach �'� h APPLICATION NUMBER
rs r -r,,P� Building Department SEP 1 2 2016 (To be assigned by the Building Department.)
800 Seminole Road I ' — C F2 _ �33
! Atlantic Beach, Florida 32233-5445 J
clii."
Phone(904) 247-5826 - Fax(904)247-5B�'S_
an qr E-mail: building-dept@coab.us Date routed: a l L l
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
D2 _
Property Address: 18j 1- I 'rL'M)'l- lc LICE( Department review required Yes No
uildin
Applicant: R l VF fL�S(4C arming &Zoning
ree minis rator
Project: I')E P K ublic orks
ublic Utilitie
Public Safety
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
1/1 St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
iaReviewing Department First Review: [Ipproved. ❑Denied. N2-4
(Circle one.) Comments: 1ec Amdliej Cooti
BUILDING /
PLANNING &ZONING /
Reviewed by: `�/� Date /(J /
TREE ADMIN. ['Approved Second Review: roved 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
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3,1";2?
City of Atlantic Beach APPLICATION NUMBER
tiP , • Building Department (To be assigned by the Building Department.)
- ' 800 Seminole•
Road I S _ 2
� ' Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 •
,10219.- E-mail: building-dept@coab.us Date routed: t L
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I aozi- PDC-4\W Department review required Yes No
uildin
Applicant: Rl VE ja t c�_ anning &Zonis
ree Administrator
Project: f Gl:� F ublic works
�$ublic Utilitie
Public Safety
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: Micoproved. ['Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: r() `
Date: 9,-do-16
TREE ADMIN. ['Approved Second Review: roved 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
BUILDING PERMIT APPLICATION
OFFICE COPY CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 (p_ S ER — 2.033
Job Address: 1804 Atlantic Beach Drive Permit Number:
Legal Description Lot 64 Atlantic Beach Country Club Unit 2 67-132 08-2S-29E.185 Parcel# 169505-1615
Floor Area of Sq.Ft. Sot-Ft
Valuation of Work$ 450,000 Proposed Work heated/cooled 2846 non-heated/cooledide A)? S"`
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed stru re(s) (circle one): Commercial : - identi.,e
If an existing structure,is a fire sprinkler system installed? (Circle one): 'es N/A
Florida Product Approval#
For multiple products use product approvalorm
Describe in detail the type of work to be performed: New construction- SFR
Property Owner Information:
Name: Riverside Homes of N. FL,Inc Address: 12276 San Jose Blvd., Ste. 120
City Jacksonville State FL Zip 32223 Phone 904-503-7055
E-Mail or Fax(Optional) Ibishop@myriversidehome.com
Contractor Information:
Company Name: Riverside Homes of North Florida,Inc. Qualifying Agent: Matthew Roberts
Address:12276 San Jose Blvd., Ste. 120 City Jacksonville State FL Zip 32223
Office Phone 904-503-7055 Job Site/Contact Number Same Fax#N/A
State Certification/Registration# CBC 1254135
Architect Name&Phone#NE FL Design,Inc 904-260-3319
Engineer's Name&Phone# Apex Technology 904-821-5200
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 sus n
ended or abandoned for a veriod of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical'Work,Plumbing,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 VOTTR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
OFFICE COPY
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: /I? 9-070-,)0/4
Development Size
Habitable Space 1kV6 C,F,Non-Habitable /0q5 S r
Impervious area
Miscellaneous Information
Occupancy Group R - 3
Type of Construction V 5
Number of Stories
Zoning District /-1C.
Max. Occupancy Load
•
Fire Sprinklers Required
Flood Zone X
Conditions/Comments:
•
r
�S 0 tiv r
:_:: j CITY OF ATLANTIC BEACH
- PUBLIC UTILITIES
`` 1200 Sandpiper Lane
ATLANTIC BEACH,FL 32233
011191' (904) 270-2535 or(904)247-5874
NEW WATER/SEWER TAP REQUEST
Date: e7._ / 3 -/(o Project Address: /80V ,1 j C (i Dr.
No. of Units: I Commercial Residential ✓ Multi-Family
New Water Tap(s) &Meter(s) Meter Size(s) q
New Irrigation Meter ✓ Upgrade Existing Meter from to (size)
New Reclaim Water Meter Size '7 ,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# /(o--5rei - 20 33
Water System Development Charge $ 4,NO. 00
Sewer System Development Charge $ %05UU. GYM .-
Water Meter Only $ /8S.00 ,31 p
Reclaim Meter Only $ /&f 00
Water Meter Tap $ (notes)
Sewer Tap $
Cross Connection $ ASO. D0 /
Other $
TOTAL $S,(ai D,00
APPROVED: Kayle Moore,PE K I'/i
(Deputy PW Director or Authorized Signature)
ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES
CAN BE ASSESSED
_ OFFICE COPY
�S� CITY OF ATLANTIC BEACH
:•-••,.... j
.., CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
800 Seminole Road 904-247-5800
=ursAtlantic Beach,Florida 32233-5445 Fax 904-247-5845
PLEASE SUBMIT(3) COMPLETE SETS OF PLANS WITH APPLICATION.
Date Ci`1,1g,
PERMIT# '
Job Address t A1C _1Qa.� !xi v-L ISSUED BY THE CITY /6— SPi '- .70�
Permitee: � V
1Q.r16Q -1omeS a N. Ct...)I N e. Telephone# qc4-a- 3--1055
Permittee Address: lap-1u ScuiJOSe_ 131\16) 4 lab, acy60NJv 11Q1 t-L 3x223
Requesting Permission to Construct: New C I, -ruC*1ON- SVR
Location: (Reference to Cross-Street)
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 Florida De a ment of Transportation Standards and be
performed under the supery ion of (��j�( e' L .\ < (Contractor's Project
Superintendent) located at }lives-3.C'kQ -IC:t ne_3 Telephone#: (:)..3'—JOSS
P )
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 ‘.-2)(7 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 interest in 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 and
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 P =tic Works shall be notified twenty-four (24) hours prior to starting work and again
immediately u•• 0, pletio .
z:cOWNER / .71/4„,ik_ :
Signed: AL,14r Date: CI-,I
Before m is .—I day of in the County of Duval,� _ _
State Of Florida,has personally appeared ( 1C!'•S tAlelN
Notary Public at Large,State of Florida,County of Duval. ss: "°; '•,, LINDSEY M.SISHOP I
My commission expires: Personil 1+ s Nptny PYOIIC.State of Fame I
Produced Identification: ( N, ,'i` Commission 0 FF 945204
• ,PA' My Comm.Expires Jan 19,2020 0
4
OFFICE COPY
R.O.W. Permit Attachment of for
R.O.W. Permit# issued , 200_ Atlantic Beach, FL 32233
Owner's Name: (RtJW,t( OF Ni•
Property Address: I 8tif Alicervfic, i ' 1 DY;
M-lar-H c teach FL 322-2,3
Subdivision: L •(., •le1 Cbtothejedulo
Lot#/Block#: ?'
R.E. #: 1(0456 6't6
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this —j day of
`..ej) , 201* by Atlantic Beach, Florida, a municipal corporation organized and existing
underthe laws of the State of Florida, hereinafter referred to as "CITY" and Riverside_ -IOM2S
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: 1\19.-U...) CONS*ru. 11*N — Sr iZ
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:
s� O
1 Daitu.I Jose BWe .5t t 4€ wo, aeiC eNvi Ile, rL. 3.13D3
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 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.
DATE P . , ( NED this '1 day of , 20(14
411P
By 1�_ si
Pr, Prner .
. . signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this 7 day ofty , 2040, personally appeared before me, a Notary
Public in and for said Co and State, /'IS Nano( , the property owner of
}- 1o14 , 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 mentioned.
A q3lig
' 4►PYP IINDSEV M.BISHOP
Not ublic in or said Cod State I ', .1�N Notary Public-State of Florida I
:,n,� II = Commission M FF 948204 I
CITY OF ATLANTIC BEACH, FLORIDA, a ,,� My Comm.Expires Jan 19,2020
municipal corporation:
Approved:
Ricky L. Carper,Public Works Director
For Permits where city sidewalk is impacted,
City Manager approval required:
Jim Hanson, City Manager
Page 2 of 2
OFFICE COPY
Atlantic Beach Country Club lot 64
1804 Atlantic Beach Drive
Atlantic Beach, FL 32233
Single Family Detached-Group R3
2014 Florida Building Code
James Pozetta,Architect#AR96064
103 South 18th Street, Fernandina Beach, FL 32034
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