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1885 HICKORY PAVERS 2017 Dl,,9 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 RESIDENTIAL OTHER - SINGLE OR TWO FAMILY RESIDENTIAL OTHER MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RES017-0020 Description: REMOVE CONRETE& REPLACE WITH PAVERS Estimated Value: 13800 Issue Date: 7/5/2017 Expiration Date: 1/1/2018 PROPERTY ADDRESS: Address: 1885 HICKORY LN RE Number. 172020 1330 PROPERTY OWNER: Name: RICHARDS KENNETH G Address: 1885 HICKORY LN ATLANTIC BEACH, FL 32233-4548 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: KETTELLINC. Address: 1880 MAYPORT RD ATLANTIC BEACH, FL 32233 Phone: PERMIT INFORMATION: Please see attached conditions of approval WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. * A notice of Commencement is only required for work exceeding an estimated value of $2,500. For HVAC work, a Notice of Commencement is only required when HVAC work exceeds and estimated value of$7,500. Conditions Permit City . f Atlantic Beach Permit Number: RES017-0020 Description:REMOVE CONRETE&REPLACE WITH PAVERS Applied:6/7/2017 Approved:6/27/2017 Site Address:1885 HICKORY IN Issued:7/5/2017 Finaled: City,State Zip Code:Atlantic Reach,FI 32233 Status:ISSUED Applicant:<NONE> Parent Permit Owner:RICHARDS KENNETH G Parent Project: Contractor:<NONE> Details: LIST OF c D SEQ NO ADDED DATE REQUIRED DATE SATISFY DATE TYPE STATUS DEPARTMENT CONTACT REMARKS 1 6/12/2017 EROSION CONTROL INSTALLATION INFORMATIONAL PUBLIC WORKS Scott Williams Notes: Full erosion control measures most be Installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line(247-5814) to request an Erasion and Sediment Control Inspection prior to start of construction. 2 6/12/2017 ON RUNOFF INFORMATIONAL PUBLIC WORKS Smtt Williams Notes: All runoff must remain on-site during construction. 3 6/12/201] ROLL OFF CONTAINER INFORMATIONAL PUBLIC WORKS Scott Williams Notes: Rall off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapell's,Inc.,Republic Services). Container ran not be placed on City right-of-way. 4 6/12/2017 RIGHT OF WAY RESTORATION INFORMATIONAL PUBLIEWORKS Scott Williams Notes: Full right-of-way restoration,including sod,is required. 5 6/12/2017 MAXIMUM DRIVEWAY INfORMATIONAL PUBLIC WORKS Scott Williams Notes: Maximum driveway width within the City right-of-way is 20'. /9 Printed:Wednesday,05 July,2017 1 of 2 ry J Permit Conditions of Atlantic Jfl p� 6 6/12/2017 REVISION INFORMATIONAL PUBLIC WORKS Scott Williams Notes Any plan change must be submitted as a Revision to the Building Department. ] 1 6/26/2017 1 METER BOX SEWER CLEAN OUT INFORMATIONAL PUBLIC UTILITI ES Kayle Moore Notes: Ensure all meter boxes,sewer cleanouts and valve covers are set to grade and visible. 8 6/26/2017 RTI SEWER CLEANOUT INFORMATIONAL PUBLIC UTILITIES Kayle Moore Notes: A sewer cleanout must be installed at the property line. Cleanout must be covered with an RTl concrete box with metal lid. Cleanout to be set to grade and visible. 's Printed:Wednesday,05 July,2017 2 of 2 I City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road _ v0Z O Atlantic Beach,Flonde 32233-5445 Phone(904)2475826 Fax(904)247-5845 - E-mail. building-dept@coab.us Date routed: EFY - -- City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: I RFjS �4l k0n Qn f De rtment review re uired Yes No // ,� I N uildin Applicant: I\P ITe_1[ 1 _ P19fining BZonl Tree or Project: A-V Pf miis Wo s Uli" Coto CjLe' Zc' Public Safety Fire Services 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 L]A Reviewing Department First Review: pproved. ❑Denied. . ❑Not applicable (Circle one.) Comments:.e ,O BUILDIN ''UU PLANNING&ZONING Reviewed by: Date: 6-tae-r7 TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. . ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. . ❑Not applicable Comments: Reviewed by: Date: Revlsed 05PIWO117 City of Atlantic Beach APPLICATION NUMBER ;3 Building Department (To be assigned by the Building Department.) 800 Seminole Road /�Oz O Atlantic Beach,Florida 322335445 _ VV Phone(904)247-5826 Fax(904)247-5845 / E-mail: buildingAept@coab.us Date routed: t0 7 City web-site: htpr//www.coab.us APPLICATION REVIEWANDTRACKING FORM CX Property Address: I 44 tCk 1.o De rtment review required Yes No 11 uildin Applicant: I�e �� l NC _ nning &Zom Tree mi or Project: ��AV�ILS — 2jC P 4CC_ Icwo s ColaPublic LFG_C Y� Utile Safety Fire Services 111111111W.__ Dept Signatu Other Agency Review or Permit Required Review or Receipt Date Florida Dept of Environmental Protection of Permit Verified B Florida Dept.of Transportation St.Johns River Water Management District Anny Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other. APPLICATION STATUSrrr---�� Reviewing Department First Review: ❑Approved. Denied. . ❑Not applicable (Circle one.) Comments: �C J f rT eQ BUILDING ` 6Ze0ot/otl PLANNING&ZONING ,,, Reviewed by: �r/l / Dater TREE ADMIN. Second Review: ,�/IApproved as revised. ❑Denied. . []Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: 1//e//j7 FIRE SERVICES Third Review: []Approved as revised. ❑Denied. . ❑Not applicable Comments: Reviewed by: Date: Revised 05119/2017 CITY OF ATLANTIC BEACH J� 800 Seminole Road Atlantic Beach,Florida 32233 Telephone(904)247-5800 FAX(904)247-5845 REVISION REQUEST SHEET OR CORRECTIONS TO REVIEW COMMENT Date: Received by: Resubmitted: PermitN her { F-So17 - Oct Z0 Original Plans Examiner: Project Name: Project Address: ok n rcf L� '2 Contractor: I<6T'ri✓l� INt_ Contact Name: Contact Phone : 3 -7-7- 77-7-(o Contact a-mgil: 1 n e (<6T T E.LLtNC , 00r.-\ Revision/Plan Check/Permit Fee (s)Due: $_ Description of Proposed Revision to Existing Permit: T2Er- AFF(081J (T Additional Increase in Building Value: $ Additional S.F. Site Plan Revised: Public W/U Approval: By signing below.I(print nvu) affirm that the above revision is inclusive of the proposed changes. Signature of Contractor/Agent(contreaor must sign if increase in valuation) Date once Use Only Dew App.M: Rjccted: Notified by: Plan Review Comments: Department review required Yes No Building -Danning&Zontn Tree Administrator O / Plans Examiner Public Works 7 Public Utilities Public Safety Date awa Fire Services v City of Atlantic Beach APPLICATION NUMBER s Building Department (To be assigned by the Building Department.) n 800 Seminole Road _ vOZ O j Atlantic Beach, Flonda 32233-6445 Phone(904)247-5826 Fax(904)247-6845 / E-mail: buildingdept@ooab.us Date routed: &1-747 City web-site: http://vwmcoab.us APPLICATION L.REVIEWANDTRACKING FORM Property Address: I CJOS ICy kor owf , De artment review required Yes No / uildin Applicant: J\P.tjem 1 N o _ nning&Zoni Tree m a or Project: ISA-VAS Pr �(`F Icworks COnDCRC—Y� icSaf ' Public Safety Fire Services keview fee $ -beR 9S1gnaf rue . Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept. of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management Distnct Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. �/ /❑jDenied. ❑Not applicable (Circle one.) Comments: 4e fr ']Y/1Jrrvlt �� BUILDING V 77�/ PLANNING&ZONING Reviewed bye r Date: TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. . ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. . ❑Not applicable Comments: i Reviewed by: Date: Revlse4 0M19/2e17 ?f rl irir, CITY OF ATLANTIC BEACH J 800 Seminole Road �l JAN 2 2�� Atlantic Beach,Florida 32233 r Telephone(904)247-5800 .. "� by; FAX(904)247-5845 REVISION REQUEST SHEET OR // CORRECTIONS TO REVIEW COMMENT Date: . ( /^-7 Received by: Resubmitted: Permit her ES01'1-0020 Original Plans Examiner: Project Name: Project Address: kur .dam r r -;,2z33 Contractor: ,\ Contact Name: (:,4k (ye*r(ii ContactPhone :_ 904- 3 Aq-1001? Contacte-mail: Revision/Plan Check/Permit Fee(s)Due: $ Description of Proposed Revision to Existing Permit: t:C. G-r0 Additional Increase in Building Value: $ Additional S.F. Site Plan Revised: Public W/U Approval: By signing below.I(Print Rene) affnm that the above revision is inclusive of the proposed changes. Signature of Contractor/Agent(Contractor must sign if increase in valuation) Date Office Use Only Dec '__�� APProved:f} (�[ Rejected: Notified by: Plan Review Comments: Department review re aired Yes No Building Planning &Zoning Tree Administrator Plans Examiner Public Safety Date crwwansn<a...r Fire Services City of Atlantic Beach �"�/ 1APPLICATION NUMBER Building Department ! O� (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach,Florida 32233-544 Phone(904)247-5826 Fm(904) 15845 E-mail: building-dept@wab.us Date routed: 7 City web-Site: hap://www.wab.us - APPLICATION REVIEW AND TRACKING FORM Property Address: I VOS U4I0_k0Ey LC, 1 De end review required Yes No / uildin Applicant: I\ P.tj2-t� 1 tve_ nning&Zonl ,rte Tree m or Project: I' A V F ILS - R�:PLAL`� °W� a c Utili Corp CP C Yc— Public Safety Fire Services F.Wew fee $ 2:r Depf`Signa Other Agency Review or Permit Required Reviewor Receipt Date of Permit Verified B Florida Dept.of Environmental Protection Florida Dept.of Transponation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other. APPLI ATION STATUS Reviewing Department First Review: pproved. ❑Denied. . - ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING k k3 t Reviewed by: i Date: 7 TREE ADMIN. Second Review: roved as revised. Denied. . ❑App ❑ ❑Not applicable PU ORKS Comments: LIC UTILIT S G-/2-fes PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. . ❑Not applicable Comments: Reviewed by: Date: I Revised e5HW2017 OFFICE COPY p ' BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH DATE �P/7117 " - 800 Seminole Road,Atlantic Beacb Fl,32233 a 9P 1q efJI J Office:(904)247-5826 • Fax:(904)247-5845 R C S O(-7 _ OOZ Q rl![ Job Address: ( Gi �✓J I o1 4 �a+�e Permit Number: Legal Description Rr# 1-1 UZ64M 31-1a 09-15-29E Valuation of Work(Replacement Cost)S ITHeated/Cooled SF Non-Hemed/Cooled -� • Class of Work(Circle one): New. Addition 61tisrat,?D Repair Mov Pool Window/Door • Use of existing/proposed structure(s)(Circle one): CommercialResrdential • If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No 6D • 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: y, Pur•law W Lrtl� �veu ,wdkdr s •� Mu I & 0/ficlf Wr/y Florida Product Approval# for multiple products use product approval form Property Owner Information C 'J Name: P 1� 63Qd Address: �n. Sr/tf y L<..t City64,eA State)SLZip �Zz;>' Phone 9'0 1Y 9/O 4-709 E-Mail ki em Akl Owneror Agent (IfAgen4PowerofAft."orAgency 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 NOTOE OF COMMENCEMENT. Contractor Information: 1yI/' Name of Company: Quaff in Agent: e_ K ct I e� Address: P7 s City CPyr State Zip FC 3LZ33 OfficcPhorMaY M 17zaJob Site/Contact Number o 3 State Certification/Registration# Ila P, E-Mail in ;0 /�fits G1 ' i - i•..� Architect Name&Phone# Engineer's Name&Phone# KI Worker's Compensation Oq ALe - Exempt In'l saver t Lease,Employees I Farpnahan Date App/icafian is hereby mode to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced poor to the issuance ofa permit and that all work will be performed to meet the standards ofall laws regulating construction in this jurudidion. %'his permit becomes null and void ijwork is not commenced within six(6 onths, ar if construction or work is sus e r abandoned a,. period ofsix(6)months at airy time offer work is com d I urdersm�that separate permits must be secured for rt/Work,Plumbing, Signs, Wets,Pools,Furtmees,Bailers,Neuters, T tm Arr Condniorters,ete Signature ofPrope Owner: / / � Si�aNre of Contractor: Befo e this Day of [9 Q-- ( Before me t}ds Day o �Q �17 N .�N Notary Public: �- Iw: =`°'' "i+. MY COMMiSSIQY pFF824951 i;}�%a8 E%PIPE6'.OcloEer 6,2019 —'" TONIGINGLFSPEaGEP s'< nd No:rsv auom menmurs 4951OFF�gg 4'- INi I he P nx �ined this application and know the sa 'taYte 11J>� r��(jEpaftt�2Tlmvi of laws and ore gaveout t vis type oI work wi(i be complied with whether sped to ;$r P1 ,,gf5yatifitq.of�a er ermtr !ructies donot presume to givautho e rity to vio ate or cancel the provisions of arty other fe er 'oon or the performance ofconstnmhon. Rev.5Y2116 i Z ti w -s r 'L z TREE & VEGETATION AFFIDAVIT ?, City of Atlantic Beach i Department of Community Development Planning&Zoning Division 8005eminoleRoad Atlantic Beach,FL 32233 (P)904247-5800 (F)904247-5845 PERMIT# SECTION I-APPLICANT INFORMATION F- Owner(s) OCLegal Authorized Agent' NAMEOFAPPLICANT j � � Hp&v- dw✓izr - NAMEOFCOMPANY ADDRESS OF COMPANY , PHONE ! 177 CELL ey 377 EMAIL i/17tj ii ��nL LD^-+ CONTRACTOR CERTIFICATION NUMBER ATLBCH BUSINESS TAX RECEIPT NUMBER /V7/f/It/�4 tiW SECTION II-SITE INFORMATION STREET ADDRESS OF PROPERTY A96 �,�� -y �,,,� - 'F� Esa7- 00zC) Iran address ha,notbeen ossignedw mispropero,o uwathem Building Department at(904)147-5826 toreguest on address. LEGAL DESCRIPTION LOT BLOCK SUBDIVISION 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 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,l affirm that no regulated Hees and no regulated vegetation will be damaged,destroyed and/or removed from theabovedescdbedoradjacentpropertiesin conjunction with thisproject. IGH TUREOF / SIGNATURE OFOWNER Iat�/ Sign "ndswom before me on this/(laygf3 7� ( /,by State of t l � 444------ —1 County of �1� J� Identification verged: L 5 zO g OS- — fp:s• 6— 0 _ R Oath sworn: r: Yes r N � C)J - ga MISSIQNYTGNIGItNIEBPFA :i GER 4 iaMY WMFF814951 wFXPIRES:OcroEaz&2019 NotaryIgnature so"m9mry xnvryc�cr<una.rwmrs My Commission expires: RTW R.O.W.Permit Attachment of for R.O.W.Permit# issuedr /� ,20_ Atlantic Beach,FL 32233 Owner's Name:�B/v t C K I C h c,, -s Property Address: CJCo 37 -aN Subdivision: Col io W1 r)dcg (rr1`-I /;L R.E.#: I '7 Z OZ O — 4_c; 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 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: � V —C 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: 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 I 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 this day of 2017 By: 'Property Owne (to be signed in presence of the Notary) STATE OF FLORIDA COUNT DUVAL I 7 On this day of �J C9 !t'ei 20J7 I, personally appeared before me, a Notary lexecuthe nd f r said County and State, r( Q , the property owner of , Atlantic Beach, Florida, known to me to be the persons) and who execut the foregoing instrument; who acknowledged to me that he or she same fevolun / ilyand for the uses and purposes therein mentioned. C./ Notary Public in for said County an e MY co GIND1E0FF9P MMISSWNYFF924951 yF vG 2019 EXPIRES alober', :L CITY OF ATLANTIC BEACH,FLORIDA, a municipal corporation: Approved: illiams / A Interim Public Works Director File: 12/12/16 Page 2 of 2 T ',F- a �,A^�i�� tea-iC�� t,n .•Yl, o;a.- Cis ;.� lF-I clao� Ld HICKORY LANE leo' Rart a wAh ��_ 00'24'53' W 85.00' (PIAT) h2j r I'15'5W W 85.4& (MEASURED) o } y Q 0 m � < D SLD m c -o 100 c: m ; / fir / \ d : ) \ ` � O , lq � / § f \ 2 � ` mac) . CnI � A \ \ ) | § § § f \ ! » " mom �9 : \ \ � ( \ V § \ \ 2z ` � � \ § §® :` ■ , . . . ® RKY ( ( eq § z / \ 14 @ � // Fn/\ s ! I! . (, a � /� ; ; ' _ 7k _ \§ \ ; s