462 INLAND WAY - ADDITION PERMIT ‘, .
\�� CITY OF ATLANTIC BEACH
w.. ,,,_,J,,,,,
r- N.9 800 SEMINOLE ROAD
J
„r ATLANTIC BEACH, FL 32233
:� INSPECTION PHONE LINE 247-5814
Jill
_1yii_.. E E€+P eAt PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-RADD-1017
Job Type: RESIDENTIAL ADDITION
Description: ADDITION
Estimated Value: $60,000.00
Issue Date: 6/2/2016
Expiration Date: 11/29/2016
PROPERTY ADDRESS:
Address: 462 INLAND WAY
RE Number: 169463-1540
PROPERTY OWNER:
Name: HAMANN,CHRISTOPHER G & LISA R, *
Address: 462 INLAND WAY
GENERAL CONTRACTOR INFORMATION:
Name: PHILLIPS BUILDERS LLC
Address: 1250 SELVA MARINA CIR QA BARBARA CAROLINE
PHILLIPS
Phone: - -
FEES:
ENG REV RESIDENTIAL BLD $100.00
PLAN CHECK FEES $160.00
UTIL REV RESIDENTIAL BLDG $50.00
BUILDING PERMIT FEE $320.00
STATE DCA SURCHARGE $4.80
STATE DBPR SURCHARGE $4.80
Total Payments: $639.60
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
r1:LYrJ�� City of Atlantic Beach 3T � APPLICATION NUMBER
, Building Departments (To be assigned by the Building Department.)
,�� ) 800 Seminole Road w1�
!:)c �r Atlantic Beach, Florida 32233-5445 /�~ A A/ - 117
Phone(904)247-5826 • Fax(904)247-5845
'"1.on �� E-mail: building-dept@coab.us � Date routed: -- Ar /
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 16 1 _ I, / / 3 - • • I ent review required Yes No
, 40"1"11._2--- 1111111111111111.11111.1
Applicant: A ( /_ _, A & Ib. 4 - -i i i•&Zon_•
Tre- I.ii nistrator
Project:/)1 d6-Nr) ( ...blic Wo .
4-Public Ulli. 111.11M111_-
Public Safety
Fire ervices ==
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: proved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING �� �X
Reviewed by: A.,.• Date: 6
,
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied.
af,1IC WOR Comments:
PUBLIC UTILITIES�
PUBLICSAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
tevised 05/14/09
(;s1.—Til:06 City of Atlantic Beach "C�I�j�D l APPLICATION NUMBER
/j 1Building Department
` 800 Seminole Road MAY O 3 2016 (To be assigned by the Building Department.)
j> f.�r Atlantic Beach, Florida 32233-5445'>��. r �6 A A i _ 1�7
Phone(904)247-5826 • Fax(904)'247-584
J,3 o E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us Atio
APPLICATION REVIEW AND TRACKING FORM
Property Address: 16 Z. 1, i , . - • . . ent review
731) ) f9$ ) ew required Yes No
Applicant: 4 j 1 ds <s�'i• &Zonis _-
Tre
- 411111.11
a•.. nistrator
��� 14
Project:
Public UtilL____ 1111111111111111 Safety
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: Approved. ❑Denied.
(Circle one.) Comments: �/ l,,,ylll 44044_� ����
BUILDING f 41 �I 944d •'�If�/l�'�"'w
PLANNING &ZONING � /�
Reviewed by: °4' Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑ nied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
tevised 05/14/09
I “i_,z.iatkpoi 44-7 / 6 -/UN- /0/7
11.11111
-
�!I 010 u 342, afrOlt
I A g0 Ste/
r
_ ,_sr 1111111111111111
11111111111
intimmilm'A . 111111111111111
. 4,6
I y, , VIM
, %
_06 it444k
._
1 14 , r
lL,
6
_r �
ot-tv;y,, City of Atlantic Beach
APPLICATION NUMBER
d #" �� Building Department (To be assigned by the Building Department.)
J" •;) 800 Seminole Road
%-. .t 0.. e /Atlantic Beach, Florida 32233-5445 �— /Q__,,_1,0/7
\\,....
j,,, Phone(904)247-5826 • Fax(904)247-5845
_on i� E-mail: building-dept@coab.us Date routed: JO
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 6 Z // / / ._•_ ent review required Yes No
IIIIIIIMIIIIIIMI
Applicant: A ( /_ _, , A 4 PP�on_L •
f Tre- 1.•ii inistrator
Project:kbl t7-1 4-
•lic Wo .
Public Utili -
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: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: 6-7(�/(#
TREE ADMIN. Second Review: ['Approved 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
„,/1....A/J:;.4.;.
OZiati�`,, BUILDING PERMIT APPLICATION .
J r
CITY OF ATLANTIC BEACH
/ 800 Seminole Road,Atlantic Beach FL 32233
�'b'it�Y Office: 904 247 5826 •
( ) Fax: (904)247-5845
Job Address: tile 2 UettgCt Way. Permit Number:
Legal Description
RE#
Valuation of Work(Replacement Cost)$ ( COC Heated/Cooled SF (� 6.4)N n-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 Residential
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No 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:
A-ob1T1br) (oC S9 Ft
Florida Product Approval# _ for multiple products use product approval form
Property Owner Information
Name(Ele6 (,t R H-AMect.1N Address: lt-L 2- !N.--94 NO kthol
City A.g . State 1_�Zip 43 2 2-33Phone
E-Mail
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 • t : k TTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
Contractor Information: p
Name of Company: C�}i L 'LP.S�ti,Vers LLQ, Qualifying Ag, 1 SW 2 - AM I I
Address: 1 ZS`G Cel✓e MQ ivA- e i41' • City N ..Q. 1 II State Zip Pt. >)'li 3
Office Phone 101). 349-2991 Job Site/Contact Number 1111 - fill
State Certification/Registration# Cgc___ j 7 s"'7 3)4 E-Mail V .1 A I . J III
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
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,Plumbing,
Signs, Wells,lsools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc.
B Sif at the of Proper Awner: \ /`, � 1 Signature of Contracto', • ''t.' ��1�l ,”
this ('Day ofLIIa ori Before met,' Da., /l i
Notary Public: '"�''': TONI GINDLESPERGER
/�llpikI 'u MY cow SIO ,. Ir.." ' i✓y,��
r..-12,..W EXPIRES:October: 411• :1+A , r,'.' !`=MT t h3+i<la
d n°:° Bonded Thru Notary Public Underwrit /I 'fir `y- i<tti#r:i
I hereby cert that I have read and examined thi --_-.----;---.--------,-------7------..—..•, 'ra;•. h rov1s.
yt���tn t;'o - �rovtstons laws and
ordinances governing this type of work will be complied with whether specified h, e ; iot. i. •.,• - does not
presume to give authority to violate or cancel the provisions of any other federal, . • , -g i icing construction or the
performance of construction.
Rev. 3/14/16
ot=vJrl4, City of Atlantic Beach
APPLICATION NUMBER
A' Building Department
.,. sus (To be assigned by the Building Department.)
800 Seminole Road
9 Atlantic Beach, Florida 32233-5445 — A /7
Phone(904)247-5826 Fax(904)247-5845
-..,011 9), E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 16 1 // / ent review view re uired Yes No
Applicant: rj-)1i) ( s 1 10ls 4 - . '. &Zonis__•
417)Z jTr-- �_nistrator _-
Project: � -
(Public Utili •-
FirePublic Services 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: gApproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING ���
Reviewed by: � Date: ,.s/?.6/4
TREE ADMIN. Second Review: QApproved as revised. DDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: 111Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
tevised 05/14/09
rs_A,t`,` BUILDING PERMIT APPLICATION
J ��\
CITY OF ATLANTIC BEACH
\� yr
:.� 800 Seminole Road,Atlantic Beach FL 32233
�J;i1J' Office: (904)247-5826 • Fax: (904)247-5845
, n
Job Address: .L1a
Z 1G2d Lia.. Permit Number:
Legal Description p RE#_
Valuation of Work(Replacement Cost) $ CO
d(.X Heated/Cooled SF 6- `T4T 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 Residential
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No 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:
ProbITIUo Coc SQ FT '
Florida Product Approval# for multiple products use product approval fonn
Property Owner Information
Namen-lets (A +e,jN Address: '¢'L 2- !dll�s4 MD too L
City tq.8 . State'r Zip .13 2 Z 3 rhone
E-Mail
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 R AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
Contractor Information:
Name of Company: PA-1LUPS Ijti,kiers LLC , Qualifying Ag: l 910? z - Ad I
Address: l ZS`'G cei✓+o MIQ�NI� G City J .9. I Il State Zip 1-1. F.V1.3
Office Phone 109- ,349-2-9°14 Job Site/Contact Number ILII — l III
State Certification/Registration# (( 1_t ZS"'7 3)1- E-Mail V /\ d
A
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
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 orsix(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.
Signature of Prope Awner: \ ig,:a!1� / Signature of Contracto , ' ' t) I!�IP/ "
Befine �1��Sj' /' �� •
this ('Day of ,.. ./. A Before me t e' Da "l i i I to
r7I��� _ '`' TONI GINDLESPERGER /
Notary Public: .,., . - myGOMMISSIO�5 ,,,�..y'y l `.:' ' 1.414
[._:,,3.":::=2.,..k.41EXPIRES:October: 411• '�; ��• "t.`hlrtcMP. ,SV Bonded Thru Notary Pubfic Underwrite- t. i r'_"y 4 41:4„lil'�
I hereby cert that I have read and examined thi .rr,`iz.,..l�.,....J L,,...., „1„_,,..,,� ' �frn tio.'�i " �tovrrssions .• laws and
ordinances governing this type of work will be complied with whether specified'h e e e °rot.'�4"ii> 91. •.. ,. , - , does not
presume to give authority to violate or cancel the provisions of any other federal, . .• • v t ,ting construction or the
performance of construction.
Rev.3/14/16
/► -
I' REE & VEGETATION REMOVAL PERMIT APPLICATION
INSTRUCTIONS •
City of Atlantic Beach
(1) Complete and sign this form. L Department of Community Development
(2) Attach the required supporting exhibits as listed u 800 Seminole Road Atlantic Beach,FL 32233
pP 9 on the application � r (P)904 247-5800 (F)904 247-5845
checklist.
(3) Contact the Department of Community Development if you have
questions or need assistance completing the application or r Ingle /Two Family Residential $125.00
determining which exhibits are required for your particular project. Multi-Family Residential $250.00
(4) Submit this form, along with all required exhibits and payment to
the City of Atlantic Beach,and in the a r Commercial/Industrial $250.00
appropriate amount according
to the application fees listed to the right, to the reception desk at Institutional/Other Non-residential $250.00
the Building Department.
Application#TREE—
SECTION I -SITE INFORMATION
PHYSICAL ADDRESS 41)2_ /WI)Q d w,o 11 A.8. F1. 3 Z-L33
If an address has not been assigned to this property,contact the AB Building Department at(904)247-5826 to request an address.
SUBDIVISION Ol�4 ?V A/ /'4?OCK LOT RE#
SECTION Il-APPLICANT INFORMATION r OWNER r LEGAL AUTHORIZED AGENT*
NAME OF APPLICANT P1.4.-li , S Q,/,`We�
ADDRESS OF APPLICANT12, -6 Sec FFF[[[...���IJ.NA e - A. e �!t 3 2_1,33
PHONE 904 3 .9. 2P)CELL EMAIL
SECTION III-TREE&VEGETATION REMOVAL REQUEST A'p w M&8►)
I REQUEST THAT THE TREES&VEGETATION ON THE ABOVE DESCRIBED PROPERTY AND INDICATED ON THE ATTACHED REQUIRED
EXHIBITS BE APPROVED FOR REMOVAL,AS PROVIDED IN THE CITY OF ATLANTIC BEACH VEGETATION CODE,CHAPTER 23, FOR THE
FOLLOWING REASONS(check all that apply):
1 T Vegetation(trees)are difficult to maintain/owner dislikes.
•
r Trees are dead,diseased or so weakened by age,storm,fire,or other injury so as to pose a danger to persons,property,
improvements or other trees.
r Vegetation(trees) pose a safety hazard to pedestrian or vehicular traffic or cause disruption to public utility services.
fl Vegetation(trees)pose a safety hazard to buildings or structures.
IT Vegetation(trees)completely prevent access or cross access to a lot or parcel.
Vegetation and/or trees prevent development or physical use. It is the intent of this provision that a permit shall be granted for
IT the removal of vegetation and/or trees when the applicant has demonstrated an effort to design or locate the proposed
improvements so as to minimize the removal of vegetation and/or trees.
I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED WITHIN THIS APPLICATION IS CORRECT
AND I AGREE TO COMPLY
WITH ALL PROVISIONS OF CHAPTER 3,PROTECTION OF TREES AND NATURAL VEGETATION,AND ALL OTHER APPLICABLE
COD• 'ND ••DINANC I HE OFA LANTIC BEACH.
SIGNAT.' OF APPLI ANT DATE
FOR 1�1' RNAL OFFICE USE ONLY
I
FRONTAGE FLU ZVAR ESA SR-1
DEPTH ZONING UBEX H/H SR-2 �.
AREA ISA WAIV OAR CR �,
z1
Tree&Vegetation Removal Permit Application versionoi.oi.og
Doc # 2016100614, OR BK 17550 Page 1713, Number Pages: 1, Recorded
05/04/2016 at 02:28 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
State of r( (:).._ County of Tax Folio No.
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEME
Legal Description of property being improved: 440a_ (,� -,3,00 U✓✓Qv) Q.0, Y i" 293
Address of property being improved: 4 Co Z. I p tai.-ct UPJ 63, k 3 ZZ3Z
General description of improvements: i4 0 0 17)OA
Owner: C ' w. ..r AAI Address: 1-G2_ I, /0 Let 0.0li.A..q A.IS Pt. ,2,Z4,13
Owner's interest in site of the improvement: A CO1T100 f
Fee Simple Titleholder(if other than owner):
Name: i 1. S
Contractor: P)..Lj LL, �5u, l Ks LL
Address:/ZS() L✓A l4/0f OA e--1.4-.J- l A.Q. t. b Z�2
Telephone No.ci 24/ '&2 2,q Fax No:
Surety(if any)
Address: Amount of Bond$
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:
Address:
Telephone No: Fax No:
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):
THIS SPACE FOR RECORDER'S USE ONLY OWNER , 'I '*' ' /(/L
117 •Li
Signed:.. ► / Date: 2i9 ICO
Before me this day of f--k p L 1 in the County of uval,State
Of Florida,has pers .ally appeared t es �1LZ nna-n✓j
1 Personally Known: � or
Produced Identi` ,n: H 'a:.,,ir -S .C.,-70 •7 4-C)
Atk •
•
r_ NfY 7
ti EXPIRES:October 6,2019 i
.. Bonded Toru rotary Pubic Undue t
Phillips Builders, LLC
1250 Selva Marina Circle
Atlantic Beach, FL 32233
CBC #1257314
904-349-2999
Job Address:
z.� Nei D wA Q . �= . 3z33
1 �
Erosion and Settlement Control Plan
• Install silt fence around perimeter of construction site
Site Management Plan
• Weekly inspection of all stakes throughout fencing
• Pick up any loose debris daily
• Parking will be on site
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