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73 Garden Ct ROW permit CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 RIGHT OF WAY PERMIT MUST CALL BY 4PM FOR NE)IT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-ROW-2708 Job Type: RIGHT-OF-WAY PERMIT Description: REPLACE EXISTING CONCRETE DRIVE WAY WITH PAVERS Estimated Value: Issue Date: 12/15/2016 Expiration Date: 6/13/2017 PROPERTY ADDRESS: Address: 73 GARDEN CT RE Number: 169716-0040 PROPERTY OWNER: Name: SMITH, FRANKLYN C & BETH P, Address: 73 GARDEN CT PERMIT INFORMATION: UTILITY DEPT.: PUBLIC WORKS: Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. Cleanout must be covered with an RT1 concrete box with metal lid. Cleanout to be set to grade and visible. Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line(247-5814)to request an inspection from Public Works 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(Advanced Disposal and Realco Recycling). Container cannot be placed on City Right-of-Way. Full right-of-way restoration, including sod, is required. Maximum driveway width within the City right-of-way is 20'. PERMU IS APPROVED ONLY IN ACCORDANCE WITH ALL CHW OF ATLANTIC BEACH ORDINANCES AND THE FLOMA BUILDING CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Fence/ROW $35.00 Total Payments: $35.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORIDINANCES AND THE FLIDRIDA BUILDING CODM. City of Atlantic Beach Building Department CEIVE APPLICATION NUMBER 800 Seminole Road (TO be assigned by the Building Department) EC 0 6 2016 1 ' AOW - Z 00 Atlantic Beach,Florda 32233 5445 6, V'J 2 0c, Phone(904)247-5826 - F�(904)247- E-mail: building-dept@wab.us Date routed: Cityweb-site: hfip:/A�.coalb.us APPLICATION REVIEW AND TRACKING FORM Property Address: I Department review re uired Yes No Building Applicant: Planning&Zoning Tres Administrator Project: u'c-� u lic Works ic Utilities Public Safety Fire wSeNl�sF Review fee $ ...21— Dept SignatLire 5r.� Other Agency Review or Permit Required Review t Date of Pemit=PBY f-londa Dept.of Environmental Protection Florida Dept of Transportation St.Johns River Water Management District Amy Corps of Engineers Division of Hotels and Restaura��� Division of Alcoholic Beverages and T.b.cco Other APPIL TION STATUS Reviewing Department First Review: [JA/pproved. ElDenied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: E]Approved as revised. F' ]Denied. IqWOR Comments: P2BLIC UTILITI S 7 -&-f BLIC SRAFETY f Reviewed by: Date, FIRE SERVICES Third Review: ElApproved as revised. E]Denled. Comments: Reviewed by: Date: ReA�s,105114109 CRY Of Atlantic Beach Building Department 800 Seminole Road BErEIVE Atlantic Beach,Florida 32233-5445 Phone(904)247-5826 - Fax(904)24 841)EC 0 6 20M E-mail: building-dept@mab.0 Citywelb-site: httjp/A�.00ah— n f3y'.-� APPLICATION REVIEW AND TRACKING FORM ProPertY Address:—�Z3 Gagor—o (24 a nentreview— uired Yes No 2 ild g Applicant: A.) Planning &Zoning Tree Administrator Project: uf--� u lic Works ic tilitles Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Florida Dept.of Environmental Protection of Permit Verified B D to 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: WrApprovecl. UlDenled. (Circle one.) Comments: BUILDING rPLANNING&ZONING Reviewed by: T M at/ TREEADMIN. Second Review: E]Appr-ved as revised. Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: EIAPPrOved as revised. ElDemed. Comments: Reviewed by- Date, ReAsedOW14109 CITY OF ATLANTIC BEACH CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS 0 Seminole Road 904-247-5800 Atlantic Beach,Florida 32233-5445 Fax 904-247�5845 PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION. 16,-Ro" -Z-7i Date 2�ZJ-11 Ig PE IS:11i Job Address ' 2,� 6&4l ---7- UE "THE CITY permitee: f7vi 6, fm illit Telephone# Parmittee Address: 7*3 "eii Z-r i�— k -r64 Requesting Pemnission to Construct la/le 1911 IAzV Ati :�J,VQ Location: (ReferencetoCross-Street) ti OF'r— 6;-1 JeJ , 1. Applicant declared; that prior to filing this application he has ascertained the location of all existing utilities, both Banal and underground and the accurate locations am shown on the sketches. A Letter of Notification was mailed to the following Utilities/Municipalides: Jacksonville Electric Authority Yes( ) No Date: Bell South Telephone Company Yei ) No Date: Ferrell Gas Y:s( ) Noo (k) Date: Comcast Y a ( ) N (XI 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 hemon 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 or Florida Department of Transportation Standards and be performed under the supeNision of (Contractor's Project Superintendent)located at Telephoni a-gs-T19-3 4. All materials and equipment shall be subject to inspectimn—bythe Director of Public Works or his designee. 5. All city property shall be restored to its onginal 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 thit-S& Right of Way are to be Included with this application. 7. This perninittere shall commerce actual construction in good faith with _J�i days. If the beginning date is mom than 60 days from date of pennit 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 Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon completion. OWNER Signi Date: TO,2"Iou` FFV4Zl 'a he I. (Jay of In unty of Di myWS11111 Before 0 1 State FI do,has personally ad arad EXPIRE Octotaii hichary I.aft L. Is,County of D 64 Ission,ex dres: to of Fri uvil Jill , 'p"'U'i Produced Identhicatim: CITY OF ATLANTIC BEACH (OWNER / BUILDER AFFIDAVIT 1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART I '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 CONSTRUCITUN YOURSELE. YOU MAY BUILD OR HOPROVE 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 YOUTL 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 VIOLAT10N 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. 11. 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 ANDIOR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER AN CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5.000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(l). 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. S' �DDV "AM.EOR IF_P_*A5 W N L_- m T*� PMNTNe t� e�f — I-,) /:w/ � SP"AMRE ,4 CATE Hencnermtnit. 6-- dayof D� 20JL I.thecoontlof Du'.1,State of Florda,has mraormfl��-Jnisy himself1hemelf and affirrostind all statements and deswations am two and assums, Nothary Pubil"Lame,&am of Counly of r. I TONI GINDLESPERGER E op=,=.-- 'et, My COMMISSION#IT 924951 EXPIRES!O�toberfi,2019 None,Signatum: FAB�guitdvAffdwit.�M Vlfi�lmo 1jr< 0 Ln 0 cu c FUR cc c: 2A 0 fiw m 0 z En g:gu w pmd Y*N 42 ; , i 0 CU p ao. A it 22. 2 9-115 tq AE z3z eq'41-�Ob v4l'