1667 ATLANTIC BEACH DR - NEW HOME PERMIT rCITY'' ,
OF ATLANTIC BEACH
fi �..d- J 800 SEMINOLE ROAD
J '` ' - " 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-2485
Job Type: SINGLE FAMILY RESIDENCE
Description: NEW SINGLE FAMILY HOME
Estimated Value: $424,876.00
Issue Date: 12/21/2016
Expiration Date: 6/19/2017
PROPERTY ADDRESS:
Address: 1667 ATLANTIC BEACH DR
RE Number: None
1
GENERAL CONTRACTOR INFORMATION:
Name: TOLL BROS.,INC
, CGC 1510225
Address: 250 GIBRALTAR RD STEVEN R MERTEN
Phone: - -
PERMIT INFORMATION:
FEES:
UTIL REV RESIDENTIAL BLDG $50.00
SEWER SDC-SYSTEM DEV $4,050.00
CHG
ENG REV RESIDENTIAL BLD $100.00
BUILDING PERMIT FEE $1 ,454.63
STATE DCA SURCHARGE $21.82
PLAN CHECK FEES $727.31
STATE DBPR SURCHARGE $21.82
FERMI I IS APPKrn I ONLY IN ACCORDANCE \\Il II :U.I. CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
(WILDING CODES.
I
•
r
\ -1' ` , CITY OF ATLANTIC BEACH
.. , f 800 SEMINOLE ROAD
j _, ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
.,--'----/---
Jlilrr
BD PLAN REV. 2ND $50.00
SUBMITTAL
WATER CONNECT/TAP & $370.00
METER
WATER CROSS CONNECTION $50.00
WATER SDC-SYSTEM DEV $1,140.00
CHG
Total Payments: $8,035.58
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION OFFICE COPY
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 1 67 S FR -Z 1
Job Address: 1667 Atlantic Beach Drive: Atlantic Beach, FL 32233 Permit Number:
Legal Description Lot 12 Atlantic Beach Country Club Unit 2 67-132-08-2S-29E.152 Parcel
Floor Area of Sq.Ft. S .Ft
Valuation of Work$ 424,876 Proposed Work heated/cooled 3,572 non-heatedicooled 1,465
Class of Work(circle one): ISO Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): •
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: arogers(atollbrothers.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# Toll kr-ch j rd-Ute t }ea-or ULU- (,1-i01)a - a - 6837
Engineer's Name&Phone#Lout Pont-)l,O ASSCC.• ,Grlcly KPb i CC 04) a W a- 090$
Fee Simple Title Holder Name and
Address Tp11 V 1 UnflitQ.C1 Y+TtQY 1'1Ip
Bonding Company Name and
Address NIA
MortgageIender Name and Address
NA
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, Pools, Furnaces, 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 YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined this ap lication 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 pecuj ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state, or loc. , regulating construction or the per ormance of construction.
Signature of Owner `/
Signature of Contractor //
g ' g
Print Name Steven ' Merten Division Sr.Vice President Print Name Steven R. erten Division Sr.Vice President
Before me Before me
this 2 Day of November ,2016 this_2 Day of November ,2016
Attu _L . 4� '0 II• . _
Notary Pu:is ' Notary PlitQl"\A'Aj
Revised 01.26.10
ASHLEY ANN ROGERS
MY COMMISSION#GG019753 . ...
EXPIRES August 09,2020 .2;r1'.4" ASHLEY ANN ROGERS
. c MY COMMISSION#GG019753
EXPIRES August 09,2020
;;s-Akr , City of Atlantic Beach
a3t t ' ' S, Building Department APPLICATION NUMBER
�`°"' o be assigned 71A C E IV: by the Building Department.)
4 1'. 800 Seminole Road
I.:0. . ' 9 Atlantic Beach, Florida 32233-5445 i _ ``R– Z4
- '• r Phone(904)247-5826 • Fax(904)247-5845• NOV 07
201
_on !PE-mail: building-dept@coab.us u Date routed: 1 b 4 1
City web-site: http://www.coab.us BY: _ ____
APPLICATION REVIEW AND TRACKING FORM
r
Property Address: I •& R- _. p--r 1, . _I epartment review required Yes No
02.....v....;,........
Applicant: 1 (DLL. aR„,,,, ( p , 4 -lanning &Zoning _-
Project: E EliL) [ND ( rivin i L t _ w Public W. M7J. I
�ublic Utilities
Fire Services _-
Review fee $ r,) Dept Signature ,.
Other Agency Review or Permit Required Review Receipt Date
of Permit or 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:
APPytATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING /�
Reviewed by: Date: I ll b 6
TREE ADMIN.
Second Review: QApproved as revised. ['Denied.
IC WORK Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
' Revised 05/14/09
r
t.
S 1-ANr)N.. D'I` Y OF ATLANTIC BEACH
`j' IL lf'
` � NUV 19 2016 `� ' 800 Seminole Road
r,, ~ f, . -9 r Atlantic Beach,Florida 32233
r ,-, Telephone(904)247-5800
J BY' FAX(904)247-5845
--491119'" REVISION REQUEST SHEET •
Date: 11 12S It 10 Received by: Resubmitted:
Permit Number: Ilo—SF R - 1--I'S 5 ,' "
Original Plans Examiner: Project Name: A'Ianfio laeQ(C,YI n G LI.
Project Address: IIoI-r Al lant-tc Pecich Dr.
Contractor: 1O Ltn S Contact Name: Avshl R 2XS
Contact Phone :(410 b-2113 Contact e-mail: (,IYS @'I"DI l Ot�'l CJS, O(V\
Revision/Plan Check/Permit Fee(s) Due: $ `
Description of Proposed Revision to Existing Permit:
1.4104,0 ti! a t A A_a a t l�.Yl1 '.0 .... !
t +`./r , City of Atlantic Beach
s'' '" APPLICATION NUMBER
6 ;fr \ Building Department
(To be assigned by the Building Department.)
j - A .�� 800 Seminole Road
tj— �, Atlantic Beach, Florida 32233-5445 I Co _ , t c. -Z485
allPhone(904)247-5826 • Fax(904)247-5845 l / `-C
",a;t �a E-mail: building-dept@coab.us Date routed: 1 L /4 / 1
City web-site: http://www.coab.us ![ L
APPLICATION REVIEW AND TRACKING FORM
Property Address: i G762PtTi.. .. _Iepartment review required Yes No
Applicant: --1--0 ev--) iv -lanning &Zoning _-
Project: M Eild3
IND�(� F.-4yY1ILL( w PublicW. 17P- 11111111111111111
•�ublc Utilities _-
Fire Services _-
Review fee $
Dept Signature 4 i
tiediaial
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. j2Denied.
(Circle one.) Comments: l,ic 0:11({"c ivy)
BUILDING
PLANNING &ZONING Reviewed by:��.,..�
abate: tytk/g.
TREE ADMIN.
Second Review: ,,®Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:_,�.s�ww/'4,-74%-------Date: J.�t///
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
moor
\! 1.4'A4T J, CITY OF ATLANTIC BEACH
1: : • • 800 Seminole Road
` 1 Atlantic Beach,Florida 32233
;' , }• `:' - r} Telephone(904)247-5800
FAX(904)247-5845
REVISION REQUEST SHEET
Date: l I I 2-8 I I(P Received by: Resubmitted:
Permit Number: Il0–SFR - 1--1‘&5
Original Plans Examiner: Project Name: f+Nan+iO P Qc n CDUnhld Glut
Project Address: IUU-1 it-dant-tc. gejaCh pr —
Contractor: ■ ' Contact Name: ' r— e • eS
Contact Phone • qty ' – 5 3 Contact e-mail: GlVO -e,es @1"0II .''oth-CfS,t,QM
Revision/Plan Check/Permit Fee(s) Due: $
Description of Proposed Revision to Existing Permit:
svI Iv - ---fie _Ana.Y1 I ac e,,( ,1,�.i„pfRX L -'_,_—
.s._. Prom .,i4C4.____preapeAr-bt3Ne\f2
Additional Increase in Building Value: $ Additional S.F.
Site Plan Revised: . Public W/U Approval:
By signing below. I(print name).__ If i affirm that the above revision
is inclusive of the • osed changes.
D tI a� ILP
Signature ractor/Ag-• (Contractor must sign if increase in valuation) Date
II
X
Office Use Only
Date: / 1,r Approved: X Rejected: Notified by:
Plan Review Comments:
•
I • . d I I ent review re•uired Yes No
411
de-tannin. 8r Zonin•
re- =• trator _- Plans Examiner
d Public W• �� __
I Public
Fire Services Date Created 8/20/15 Rev.2
,, S``'�'`-'r0 � ZONING REVIEW COMMENTS
S1�
City of Atlantic Beach
;--10-1;g:,:,.
Community Development Department
�, v 800 Seminole Road Atlantic Beach, Florida 32233-5445
J,�l>f• Phone: (904) 247-5826 Fax: (904) 247-5845 Email: dreeves@coab.us
Date: 11/18/16
Permit: 16-SFR-2485 Applicant: Toll Brothers
Review: 1st Address: 160 Cape May Ave, Ponte Vedra, FL 32081
Site Address: 1667 Atlantic Beach Phone: (904) 217-0739
RE#: 169505-1355 Email: arogers@tollbrothers.com
Correction Comments
1. A/C Location: The SPA text for the Atlantic Beach Country Club requires mechanical equipment to
be at least 3 feet from side property lines. Please show that this is being met or revise accordingly.
Derek W. Reeves
Planner
dreeves@coab.us coab.us
. r
'' -,
v .4 ZONING REVIEW COMMENTS
'• ._ S City of Atlantic Beach
u ' __ ;, Community Development Department
800 Seminole Road Atlantic Beach, Florida 32233-5445
44i Jit19f- Phone: (904)247-5826 Fax: (904)247-5845 Email: dreeves(a,coab.us
Date: 11/18/16
Permit: 16-SFR-2485 Applicant: Toll Brothers
Review: 1st Address: 160 Cape May Ave, Ponte Vedra, FL 32081
Site Address: 1667 Atlantic Beach Phone: (904) 217-0739
RE#: 169505-1355 Email: arogers@tollbrothers.com
,c C— 52Y
Correction Comments
1. A/C Location: The SPA text for the Atlantic Beach Country Club requires mechanical equipment to be
at least 3 feet from side property lines. Please show that this is being met or revise accordingly.
Derek W. Reeves
Planner
dreeves@coab.us
OFFICE COPY
0,IA,N, City of Atlantic Beach APPLICATION NUMBER
Building Department x `� --• '
�s� (To be assigned by the Building Department.)
A 7 800 Seminole Road
Atlantic Beach, Florida 32233-5445 9 t, NOV 0 7 2016 1 — FR- Z4&5
•
Phone(904)247-5826 • Fax(904)247-584 J;
^�Jf3 �a E-mail: building-dept@coab.us _ Date routed: 6 4 I
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 66;7 RT pu-T (? epartment review required Yes No
B. ie
Applicant: C roc-, ( _.Tanning &Zoning—
Tree •
Project:
1\\.) g) !—A 1 L�- �ublic Wgr
ublc Utilitie)
PtIbfic-Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review Receipt Date
of Permit or 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: y7/Approved. ❑Denied. /rev ."`
(Circle one.) Comments: iee /tt ,,,I
ktekat
BUILDING
PLANNING &ZONING /
Reviewed by: i Date: /� O A0
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
M44,0)66 leedukA / w
Lof 429x _� . 460
-.
4,21-
—8t1144/441,1A, X 9'
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_vrweisr7 #1.1Z , 17[
--H
R.O.W. Permit Attachment of for
R.O.W. Permit# issued , 2016Atlantic Beach, FL 32233
Owner's Name: Toll FL VI, LP
Property Address: 1667 Atlantic Beach Drive
Atlantic Beach, FL 32233
Subdivision: Atlantic Beach Country Club
Lot#/Block#: 12
R.E. #: 169505-1355
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of
, 20 , 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
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 SIGNED th'- 31 day of October ,2016.
By:
Steve Me r en, !bion Sr. Vice President, Toll FL VI, LP.
(to be si_ ed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this 2 day of November , 2016, personally appeared before me, a Notary Public in and for said
County and State, Duval, Florida , the property owner of 1667 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 purposes therein mentioned.
ASHLEYNNROGERS, MY COMMISON#GG019T53?,,,,,,. EXPIRES August 09,2020
Notary Public in for s d County and State
CITY OF ATLANTIC BEACH, FLORIDA, a
municipal corporation:
Approved:
•
. : •n, P'Mc Works Director
1)-0+-1...(..Q D, c7'es.c4)14,0t.,f-� roc
For Permits where city sidewalk is impacted,
City Manager approval required:
Nelson Van Liere, City Manager
Page 2 of 2
%
'j y� ,1 CITY OF ATLANTIC BEACH
j 1, `\�� ..�, t,� ^: 800 Seminole Road
' S C F:,i"-
;`-' Atlantic Beach,Florida 32233
'• ,..-'' ill�, J ii ��
';,}w,: ,.. ,3 , r Telephone(904)247-5800
911, ' ' ' - NOV 2 9 2016 FAX(904)247-5845
1
REV 1S!ONREQUEST SHEET
Date: 11 1 2S II l0 Received by: Resubmitted: _
Permit Number: Its-SF R -a!-H,5
Original Plans Examiner: Project Name: MA an+i Ream bourrhr j GuI
Project Address: ll(fl -Har*c Re,cich P
Contractor: ' Y Contact Name: '` r- • ••€s
Contact Phone • 4101 63 Contact e-mail: C Y r - [i ,.1"*ASA -, S e,OM
Revision/Plan Check/Permit Fee(s)Due: $
Description of Proposed Revision to Existing Permit:
'-
KSIt 2, l cW_--stau)-- --�, a Y11 CA Y1�1 u � n
bit)5 k Prom Siri -lir\L• -
Additional Increase in Building Value: $ Additional S.F.
Site Plan Revised: P03€x:Public W/U Approval:
By signing below. I(print name) chi S affirm that the above revision
is inclusive of the i . osed changes.
D I1I ,to
t
Signatue • tractor/Ag� (contractor mustsign if inerettse in valuation) Date
Office Use Only
Date:_f/ 29-4 _ Approved: Vd_______ Rejected: _ Notifiiedby:
Plan Review Comments:
. . i - II ent review required _Yes No 'I(
V
�: • �. i_—
�__ani &Zoning -._-- --.-- -_..�._ .__._...
Tre ' trator Plans Examiner
(Public WQr )
Public Utilities - �
- -2.Z 0
afety
Fire Services Cmlldt✓2NIS Rev.2
_ _
�9 - ''` J'\� CITY OF ATLANTIC BEACH
' 4= r PUBLIC UTILITIES
1200 Sandpiper Lane
ATLANTIC BEACH,FL 32233
13 f (904)270-2535 or (904)247-5874
NEW WATER/SEWER TAP REQUEST
Date: //-7—/Jo Project Address: /(o (o 7 /7.4hittc . ' t
No. of Units: I Commercial Residential ✓Multi-Family
3
New Water Tap(s) &Meter(s) Meter Size(s) /e
New Irrigation Meter Upgrade Existing Meter from to (size)
�
New Reclaim Water Meter Size �r New Connection to City Sewer
Name:
Applicant Address:
City: State: Zip
Phone Number: Cell Number:
Email Address Fax:
Signature:
(Applicant)
CITY STAFF USE ONLY
/13WaApplication# /4—SFR 2c/135--
Water
ter System Development Charge $ qo, ✓
Sewer System Development Charge $ ,/
Water Meter Only $ 18r, 6 b-, 1.:30
Reclaim Meter Only $ /Pr:CR)
Water Meter Tap $ (notes)
Sewer Tap $
Cross Connection $ ‘5D. DO .7Other $
TOTAL
$L5 /0 CJa
APPROVED: Kayle Moore,PE
(Deputy PW Director or Authorized Signature)
ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES
CAN BE ASSESSED
4
rimy• City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
res iJ� 800 Seminole Road // nn
;�� Atlantic Beach, Florida 32233-5445 l0 J�f� ` z4&
Phone (904)247-5826 • Fax (904) 247-5845
%o;ti>r E-mail: building-dept@coab.us Date routed: U. 4 i
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I i 60 R ,a co--, s, A er.pepartment review required Ye No
_ - ( ', : j ._
Applicant: l CJ Lt ��R , N3 0 'fanning &Zoning
I Tree •• • •
Project: M ELJ t toc_Th i .e rietly\ ILL( Public W
ublic Utilities)
u • Safety
Fire Services
Review fee $_ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B r�
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:
i APPLIC TION STATUS
Reviewing Department First Review: I pproved. (Denied.
(Circle one.) Comments:
(BUILDIN
PLANNING & ZONING /� �.. f
Reviewed by: O / ` ` Date: //-/ h
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. I jDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
at''L�1 r CITY OF ATLANTIC BEACH
cjs '-L �� 800 Seminole Road
•
Atlantic Beach,Florida 32233
• r Telephone(904)247-5800
�r FAX(904)247-5845
"-4Df119? REVISION REQUEST SHEET
Date: l l 12. II 1p Received by: Resubmitted: -
Permit Number: •kr)-SFR - t
Original Plans Examiner: Project Name: /} I(Ulf] aC-11 vuY ri-rt G u�
Project Address:1)1/-1 ,�tla lfiC ,CtG�h pr•
Contractor: — r Contact Name: '*.A - ••es
Contact Phone • 410y - 5 3 Cont e-mail: aVO9--ys @ foil .' Oitl-e rS,WW1
Revision/Plan Check/Permit Fee(s)Due: $ D,()C>
Description of Proposed Revision to Existing Permit:
Additional Increase in Building Value: $ Additional S.F.
Site Plan Revised: Public W/U Approval:
By signing below. I(print name) Ar' S , affirm that the above revision
is inclusive of the 1,o Jose('changes.
i(pg; ILP
Signature . actor/Ag; (Contractor must sign if increase in valuation) Date
y Office Use Only
Date: /2- /- L Approved: Rejected: Notified by:_
Plan Review Comments:
Alf roved/ a s erl , tje2 P __
• - • . n ent review required Yes No
"tanning &Zoning
Tre- Admini,trator Plans ,xaminer
Public W.
Public Utilities /2-/ •16
aey
• Fire Services _ Date CreatedSI tVts Hc.
}
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: /71k //'/7-/
Development Size
Habitable Space 3S-7 C,FNon-Habitable /4/-6 S, P.
•
Impervious area
Miscellaneous Information
Occupancy Group
Type of Construction U i3
Number of Stories a
Zoning District Distri •
cOccupancy Load
Fire, Sprinklers Required
Flood Zone X
Conditions/Comments:
OFFICE COPY
R.O.W. Permit Attachment of for
R.O.W. Permit# issued , 2016 Atlantic Beach, FL 32233
Owner's Name: Toll FL VI, LP
Property Address: 1667 Atlantic Beach Drive
Atlantic Beach, FL 32233
Subdivision: Atlantic Beach Country Club
Lot# /Block#: 12
R.E. #: 169505-1355
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of
, 20 , 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
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 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 SIGNED th'• 31 day of October ,2016.
"Ai P
By: ..S
Steve Meen, !'ion Sr. Vice President, Toll FL VI, LP.
(to be si_ ed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this 2 day of November , 2016, personally appeared before me, a Notary Public in and for said
County and State, Duval, Florida , the property owner of 1667 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 purposes therein mentioned. ASHLEY ANN ROGERS
, : MY COMMISSION#GG019753
?a• EXPIRES August 09,2020
Notary Public in for s d County and State
CITY OF ATLANTIC BEACH, FLORIDA, a
municipal corporation:
Approved:
Doug Layton, Public Works Director
For Permits where city sidewalk is impacted,
City Manager approval required:
Nelson Van Liere, City Manager
Page 2 of 2
fpepm•, i 4 /G- SfiI2 a e-/ES-
NOTICE OF COMMENCEMENT OFFICE COPY
State of: FLORIDA Tax Folio No. 169505-1355
County of: DUVAL
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 COMMENCEMENT.
Legal Description of property being improved: Lot 12 Atlantic Beach Country Club Unit 2,67-132 08-2S-29E.152
Address of property being improved: 1667 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
____Q
Surety(if any)
Address: Amount of Bond$
1 Telephone No: Fax No:
11 Name and address of any person making a loan for the construction of the imnrnvemPntc
Name: Doc#2016253531.OR BK 17765 Page 734.
Number Pages:1
Address: Recorded 11/03/2016 at 03:04 PM.
Ronnie Fussell CLERK CIRCUIT COURT DUVAL I
Phone No: Fax No: COUNTY
RECORDING$10.00
Name of person within the State of Florida,other than himself,designated b;
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 1 om the date of recording unless a different date is
specified): 11/02/2017
THIS SPACE FOR RECORDER'S USE ONLY OWNER ��
Signed: Date: 11121"
Before •- this 2 day of NCAt lNlber in the County of Duval,State
Of Flo •a,has personally appeared STEVAA e -Tt✓wi
Notary Public at Large,State of Florida County of Duval. (�
My commission expires: 531 g I�Z.0
Personally Known: V or
Produced Identification: Ai?
/1't M .v
ii"',,,' ASHLEY ANN ROGERS
';sR . �1 MY COMMISSION#GG019753
;.:7
�?,• EXPIRES August 09,2020
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