113 SEMINOLE RD - DRIVEWAY 1*,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
, f ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
DRIVEWAY - SINGLE OR TWO FAMILY DRIVEWAY
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: DWAY17-0007
Description: NEW CONCRETE DRIVEWAY AND SIDEWALK
Estimated Value: 1200
Issue Date: 7/20/2017
Expiration Date: 1/16/2018
PROPERTY ADDRESS:
Address: 113 SEMINOLE RD
RE Number: 170612 0100
PROPERTY OWNER:
Name: WHITTINGSLOW JOHN D
Address: 325 17TH ST
ATLANTIC BEACH, FL 32233-5822
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name:
Address:
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.
t r;1,.1 j.
l
rr. �if Permit Conditions
City of Atlantic Beach
\.Jit ter _ ....-
Permit Number: DWAY17-0007 Description: NEW CONCRETE DRIVEWAY AND SIDEWALK
Applied:7/12/2017 Approved:7/19/2017 Site Address: 113 SEMINOLE RD
Issued:7/20/2017 Finaled: City,State Zip Code:Atlantic Beach,Fl 32233
Status:ISSUED Applicant:<NONE>
Parent Permit: Owner:WHITTINGSLOW JOHN D
Parent Project: Contractor:<NONE>
Details:
OWNER BUILDER
LIST OF CONDITIONS
SEQ NO ADDED DATE REQUIRED DATE SATISFY DATE TYPE STATUS
DEPARTMENT CONTACT REMARKS
1 7/17/2017 DRIVEWAY APRON INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
All concrete driveway aprons must be 5"thick,4000 psi,with fibermesh from edge of pavement to the property line.Reinforcing rods or mesh are not
allowed in the right-of-way. (Commercial driveways-6"thick).
2 7/17/2017 EROSION CONTROL INSTALLATION INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
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 Erosion and Sediment Control Inspection prior to start of construction.
3 7/17/2017 ON SITE RUNOFF INFORMATIONAL
PUBLIC WORKS Scott Williams 1
Notes:
All runoff must remain on-site during construction.
4 7/17/2017 ROLL OFF CONTAINER INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Roll off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapell's,Inc.,Republic Services). Container cannot be
placed on City right-of-way.
I 5 7/17/2017 RIGHT OF WAY RESTORATION INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Full right-of-way restoration,including sod,is required.
00
Printed:Thursday,20 July, 2017 1 of 2 il
1441.
mss `' Permit Condition
'•;tit,
City of Atlantic Beach
d �r
6 7/17/2017 RUNOFF INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
7 7/17/2017 MAXIMUM DRIVEWAY INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Maximum driveway width within the City right-of-way is 20'.
8 7/17/2017 REVISION INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
!Any plan change must be submitted as a Revision to the Building Department.
Printed:Thursday,20 July,2017 2 of 2 �R
TRAM
City of Atlantic Beach APPLICATION NUMBER
J' •> ,.1 Building Department (To be assigned by the Building Department.)
r f' 800 Seminole Road f\
Atlantic Beach, Florida 32233-5445 .b\1.1 17 - OC707
Phone (904)247-5826 • Fax(904) 247-5845
-.!:,/_0;119r- E-mail: building-dept@coab.us Date routed: 7 /1 Z l 17
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: (1 S Ef v\I/uO L..(= )20 Department review required Yes No
Building
Applicant: 0 LAD 2 nning &Zoning
Tree Adminis ra or
Project:
(2_ �l Ec&)4 (�/ is Works
r r Public Utilities
S l()£ LADAt_K -- RgPc_ACc- Public Safety
G K
CST/A.DG_ 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
I Other:
APPLICATION STATUS
Reviewing Department First Review: /Approved. ❑Denied. Not applicable
(Circle one.) Comments:
BUILDING
PLANNING & ZONING Reviewed by:/f7/' Date: /, 7
TREE ADMIN. Second Review: Approved as revised. ❑Denied. I INot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. I Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
\ ,,,irL�if,J,., City of Atlantic Beach APPLICATION NUMBER
�S .�� Building Department
(To be assigned by the Building Department.)
r 800 Seminole Road
�r • v~ Atlantic Beach, Florida 32233-5445 ��A`( I `� - ��07
' (� Phone(904)247 5826 Fax(904)247-5845
�,i E-mail: building-dept@coab.us Date routed: 7 / I Z j ( 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I 1 SEVA INDO L-E )tj Department review required Yes No
Building
Applicant: 0 ti0 E 2.. lannirg &Zon i n j
nTree Administrator
Project: 0.... �f�C_� it Rl v F t,L��4 (� . a Tc Works
Public Utilities
S (0€ l,Jick(_t ^ R Public Safety
�; LACC-
X CS i r.�_GG„ 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: EillApproved. ❑Denied. ONot applicable
(Circle one.) Comments: i
j et *I tei eng• a 14
BUILDING
PLANNING &ZONING
Reviewed by--0412-0(1444°4---
Date: -1/1-17
TREE ADMIN. Second Review: DApproved 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:
Revised 05/19/2017
%t'=.''''%� Building Permit Application Updated5/5/17
rf:-, - ` City of Atlantic Beach
Qr
800 Seminole Road,Atlantic Beach, FL 32233
` •
on 9e Phone: (904)247-5826 Fax: (904) 247-5845
Job Address: U 3 115e"'�1'^-0It.. Kort of Permit Number: IWRY17 -OC�t�7
Legal Description (^0 T L 3 Z s c«,�, - •tom ko t.4 _RE#
Valuation of Work(Replacement Cost)$ t 2--417 O Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration '- . , Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial ,•esiden i.
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No CO
• 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:
Re pl kcc ey,11434-0 t.k,.' alrliciw f to 11-t cost rek-c i K of 4(e btd*4 catrek (Am-110mo(
Florida Product Approval# for multiple products use product approval form
Property Owner Information //
Name: J6NK it)k% 4"'Ilt't" Address: 3 yr I 1 4 cA—( k--�lkh,k-c- 6GL.
City , -'kik., ..... be `�- State Ft Zip 32.-7.--!3 Phone_ 't 04 -Ito SOo 44
E-Mail ..3014'kj k1C 15 63 Co RAQI ( • Co OA
Owner or Agent(If Agent,Power of Attor ey or Agency Letter Required) 0`4 "4'
Contractor Information
Name of Company: •µ"-0 w #.(.r Qualifying Agent:
Address City State Zip
Office Phone Job Site/Contact Number
State Certification/Registration# -Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation
Exempt/Insurer/Lease Em yees/Expiration Date
Application is hereby made to obtain a permit to do the work and installation s 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 the laws regulationg
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS,FURNACES,BOILERS,HEATERS,TANKS, and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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.
C i4./ .
(Signature o or Agent) (Signature of Contractor)
./ (includin: •ntractor) f
Si ned nd sworn to(or affir ed befor• a thi ! I ray of Signed and sworn to(or of i ed)before me this day of
70(/ ,by / , by
(Signature o otary) 0 (Signature of Notary)
; E 9 4tr4
Lt` ''. :4== MY COMMISSION# F 92951 '
[ ]Personally Known • ,.; EXPIRES October 6,2019 1,' [ I Personally Known OR
''' cam.' Bonded Thru Notary Public UndenritersProduced Identification
[ ]Produced Identific. iotS.,;;;,..•�'' [ 3
Type of Identification: Type of Identification:
1
•
CITY OF ATLANTIC BEACH
/�
c �J%WNER / BUILDER AFFIDAVIT
�/
•
I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "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 CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE 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 YOUR 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 VIOLATION OF THIS EXEMPTION. YOU MAY NOT
I-HRE 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.
II. 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 AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY
EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY
CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455-228(1). 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.
7e 0A-1A-44- RA 10 to _Soo(
ADDRESS PHONE NUMBER
/—d 1-4-1 it1�► r (Ow .
PRINT NAME
SIGNATURE DATE
Before me this ( ( day of 01.,j„ 201'7in the county of
Duval,State of Florida,has personally appearerin by himself/herself and affirms that
all statements and declarations are true and aate. ���\\
Notary Public at Large,State of r\ ,County of�U%10.-
❑Personally Known r 4 / 4 / ^� •3Z I^�_
Produced Identification- ` (� (0 J - TONI GINDLESPERGER
's �P�"= MY COMMISSION#FF 924951
. ' EXPIRES:October 6,2019
Notary Signature: —� /_ ' qRF e R BOndodThru NotayPuo6cUrdenmters
F:BLDGIOwner-Builder Affadavil;REVISED:4116(_009 •
46
_ CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
(f-------
800 Seminole Road--riii1.i Atlantic Beach,Florida 32233-5445 904-247-5800
Fax 904-247-5845
PLEASE SUBMIT(2)COMPLETE SETS OF PLANS WITH APPLICATION. PERMIT#
Date 7112_ 111 ISSUES BY THE CITY
Job Address I 3 Sei' eKe1C boa 44
E-mail J0kAPi,)c. IIb304, w4' 1• C°N^
Permitee: J O wt.. I,v k . +h swi s 9r,kr Telephone# 'fo`f 1 so se 0 LI
Permitee Address: 3 LC 1 "14A 5 f" 1 / -1-O kh 11(, 6 e 4- L ` F-I 3 2_Z 3 3
Requesting Permission to Construct: � tot Of t ae--w,t-.y A,1A f, t dt, ,uecklt, Act, , %atewill V.
Location: (Reference to Cross-Street) 113 5-€"41 "21 •-' "off, h,, c 1.- e.r0sS re-cr- S4.v.IOl.'ar`t.r IDS .
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: -71(2- ii 7
Bell South Telephone Company Yes -7 I ( 2 117
Ferrell Gas (X) No ( ) Date:
Comcast Yes es((?n) NoNo ( () ) Date: 7 1 'z.2 I1 ll 1
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 Permitee unless reimbursement is authorized.
3. All work shall meet City of Atlantic Beach o`Florida Department of Transportation Standards and be performed
under the supervision of -Jo 1,‘4.4 (.0 IAA Hi.n tliisLk/ (Contr tor's Project Superintendent)
located at 3 ZS 1-7 e% 4f� / thVi an�G f ekt L,Telephone#: f 0 Li - Ip—5 OO
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
I Way are to be included with this application.
7. This permittee shall commence actual construction in good faith with 60 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
all loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the h ler--_
of the aforesaid rights and privileges. t, °[E
;INN
9. The Director of Public Works shall be notified twenty-four(24) hours prior to starting work and again immediatefr T_;
upon completion. !ir,),- €s
ujUQa'.i
OWNER '= U' 1;
Si ed: kkic( / > �
Sig Date:-71 Before me this / ( day �=w LI I:
_ of J_ ' , ' the County of Duval, State Of Florida, has personally appeared
,�., i°Nic k ---1
Notary Publ c at Large, State of Florida, County of Duval. My
14 MY Cc rnrs510d9 ®xpi es:
y °, EXPIF.�• ' .* 4 _ Personally Known:
;r? Bandedr.r.,')., Prod rc id ntificatio
p`.;.. ` Revi 29 5
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113
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£ 61
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LOT 636
It' .c,, p
(99.86' FIELD) 'W o 9 LOT 650
100.00' ., "W
a
Q N-0 1,7' x 6' WOOD FENCE p�'
zf ---— \ x x x x x 6 WOOD FENCE
0 oa COsiCVeT'C ^ 0.3'
Q = P& v( .�I ) 5'4' WOOD CONCRETE Z .-.
. ^1\ PORCH Or �o
ro ed � \ 6°
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w0 '� 0.5'LC) LOT 65'
a •
``0 ; 22.9' 8'1/ ONE STORY MASONRY N� '
J rn� pi - CONCRETE WALKI E 3VANCE RESIDENCE NO. 113 N _ o.
II 11A '9 ONE STORY SHED
0 0 8 o�.
Z o CONCRETE �s SHED ENCROACHES
m ��j 4 6 In N ri 24.6' !li BLOCK 0.6' TO BLOCK WALL
RQ iv.. c0 15.5' 4.8' li WALL
�_--3.0' �� 6' WOOD FENCE
A n 0.2'� TO LINE
V J RI §tot! o x0.5'4 0.4' 8' WOOD FENCE —
o �
``a CC
I 100.00' ,
oI- x (99.98' FIELD)
1 Z W LOT 652
LOT 638 a
m
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0
Ir)
STURDIVANT AVE\ UE
(FORMERLY LAKEVIEW AVENUE) 50' RIGHT-OF-WAY
NOTES:
1, THIS IS A BOUNDARY SURVEY.
2. ANGLES PER FIELD SURVEY.
3. NORTH PROTRACTED FROM PLAT,
4, NO BUILDING RESTRICTION LINES PER PLAT,
SURVEY W
THE PROPERTY SHOWN HEREON LIES IN FLOOD PAIS RICA GREENAS MADE FOR THE BENEFIT OF
ZONE "X" (AREA OUTSIDE 500 YEAR FLOOD
PLAIN) AS DETERMINED FROM THE FLOOD
INSURANCE RATE MAP, COMMUNITY PANEL
NUMBER 120075 0001 D, REVISED APRIL 17,
1989 FOR ATLANTIC BEACH, FLORIDA.
ift\*-5 .7-31 - C
'NOT VALID WITHOUT THE SIGNATURE AND THE STEPHEN W. CREWS, P.S.M.
ORIGINAL RAISED SEAL OF A FLORIDA LICENSED FLA. LIC. SURVEYOR AND MAPPFR Nn I c cooa
SURVEYOR AND MAPPER.` _