277 15TH ST - DRIVEWAY ' s CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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: DWAY17-0016
Description: paver driveway &sidewalk
Estimated Value: 3000
Issue Date: 11/8/2017
Expiration Date: 5/7/2018
PROPERTY ADDRESS:
Address: 277 15TH ST
RE Number: 170382 0000
PROPERTY OWNER:
Name: LUCCA JOSEPH A
Address: 277 15TH ST
ATLANTIC BEACH, FL 32233-5725
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Beautiful Blooms
Address: 10418 New Berlin Road #126
Jacksonville, FL 32226
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.
rr,, ' ' ' ` Permit Conditions
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Permit Number: DWAY17-0016 Description: paver driveway&sidewalk
Applied:8/24/2017 Approved:11/6/2017 Site Address:277 15TH ST
Issued: 11/8/2017 Fineled: City,State Zip Code:Atlantic Beach,Fl 32233
Status: ISSUED Applicant:<NONE>
Parent Permit: Owner: LUCCA JOSEPH A
Parent Project: Contractor:<NONE>
Details:
LIST OF CONDITIONS
SEQNO ADDED DATE REQUIRED DATE SATISFY DATE TYPE STATUS
DEPARTMENT CONTACT " REMARKS
1 11/6/2017 DRIVEWAY APRON INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes: '
ncrete driveway aprons must be*5, 'thick 4000.psi,with fibermesh7from edge of pavement<to the property line,Reinforcing All'co y� p pReinforcing rods or mesh are
not allowed in the right of-way. (Commercial driveways :6"thick). .:' -
2 11/6/2017 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):W
247-5814)to`request an Erosion and Sediment Control Inspection prior to start of construction'
3 11/6/2017 ON SITE RUNOFF INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
All runoff must remain on-site during construction ' '
4 11/6/2017 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,.Ind,Republic Services). Container cannot
be.placed on City right of way. E r° . '._.
5 11/6/2017 RIGHT OF WAY RESTORATION INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Full right-of-way restoration,including sod,is required:,
Printed:Wednesday,08 November,2017 1 of 1 �N
V< ,,, r City of Atlantic Beach APPLICATION NUMBER
�v, Building Department (To be assigned by the Building Department.)
b.,. .� 800 Seminole Road
v'r' . = Atlantic Beach, Florida 32233-5445 ,.6 W A :.I 1-,0 p �j -
�� Phone (904)247-5826 • Fax(904)247-5845
.4-1700- cj1. t
P E-mail: building-dept@coab.us Date routed: �0 Ick'f I
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Q-1-1- t,s� T . Department review required Yes No
Building
Applicant: Is.efu-k- t, U..ot in S `Planningoni
Tree Arc ministrai:or
Project: y Q-o 0.-( A.11 3.��d--y 4S.AXIL � (ublic Mikis-2)
Public Utilities
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. 7Denied. ['Not applicable
(Circle one.) Comments:
BUILDING ree5
.c. -&ZONINGW ,,�
Reviewed by: Date:P2-44'11-1 7
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑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
, CITY OF ATLANTIC BEACH
Al, :. "'„,*, t 800 Seminole Road
Atlantic Beach,Florida 32233
REVISION REQUEST /CORRECTIONS TO PLAN REVIEW COMMENTS
Date -2-g7/7 7 Revision to Issued Permit Corrections to Comments Permit# OW RLI 17- 00!
Project Address 2. 7 7_ lS 1 4 r7
Contractor/Contact Name gecz v vL7 4// 6j Add--)71_,s-
tivwue
Phone 3 c)2 , 76'0 1,23e Email J ere,liaaice___@,IJQnZ. �P ti ev ce,n+,
Description of Proposed Revision/Corrections: Permit Fee Due $
nnnn ''
( re-e— �`C4C VL4
Additional Increase in Building Value $ 77 Additional S.F.
By signing below,I affirm the Revision is inclusive of the proposed changes.
(printed name)
Signature of Contractor/Agent(Contractor must sign if increase in valuation), Date
(Office Use Only)
Approved I Denied Not Applicable to Department
Revision/Plan Review Comments
Department Review Required:
Building
. 'a i.ngu.7,ofin.g� eviewed By
Tree Administrator
Public Works e"---3 ----I 7
Public Utilities
Public Safety Date
Fire Services
401Avtiiit, City of Atlantic Beach APPLICATION NUMBER
-; ' Building Department (To be assigned by the Building Department.)
. s *`" 800 Seminole Road --
.0 i .QW Al 11--00(o
r Atlantic Beach, Florida 32233-5445 1 i
p_ \
►*..
Phone(904)247-5826-• Fax(904)-247-:5845 DI:fronted: 00 SQ 114 -
yr „i, E-mail: building-dept@coab.us NOV 0 3 40,1 , ,
City web-site: http://www.coab.us
LY
APPLICATION REVIEW AND
A. TRACKING FORM
Property Address: Q.Q.1-1-- 1.3 Department review required Yes No
Building
Applicant: a1,L- , +.\ 0-0( 1-S cPlanning Zoni
TreeArc ministrator
�P�blic V�or :_���; .
Project: CLO -f & LL )1-4 4S Abiaq\L. Q
Public Utilitics'
Public Safety
Fire Services
i eviewfee$: Dept Signature - -
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
A'PL 'ATI®N STATUS
Reviewing Department First view: 1 i pproved--n-'""--^'=` ''-- Deriied. - ONot_applicablem
(Circle one.) Comments: •
7,---_,,,,.....,_
BUILDING =_ f �_ __� ., :._ - - -
L a �I Ii-..,4 N1 �, --„..__,_ _ ed-by 2� 1
Apa.,._”
Review
TREE ADMIN. Second Review: pproved as revised. nDenied. nNot applicable /
PUBLICU1/ORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed b : f,if, �. _ Bate:
/t'/ -/7
FIRE SERVICES Third Review: (Approved as revised. nDenied. (Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
Building Permit Application ^� ,� pla eds 7
'� � �
4City of Atlantic Beach i I
:..,,.4.. . � li��i
800 Seminole Road,Atlantic Beach, FL 32233 IAUGr1) 2 3 2017
Ph11
one: (904)247-5826 Fax: (904) 247-5845 f. 11„,
Job Address: 2i 15+h Si-1aC,E1 Permit Number: p- / 11- — oo CJ
Legal Description RE#
Valuation of Work(Replacement Cost)$ M'Fp°X. JOUR Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Iteration epair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): CommercialResident'
• If an existing structure,is a fire sprinkler system installed?(Circle one): 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:
R E191,A-Ck PPcVE - e&WTLV Re C- -rM vim+ Pivoi .WAL 811 Sc/‘1-1r.
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: J dE gj >Jo'jCE- UCLA Address: 27 ) 1511't STP-C- 1
City Oef l+ State f-(r Zip X22 3 3 Phone 302 +15 0..(25
E-Mail 3Oti LUCC€ U®e L,EIOU
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: ?&/tlJT1 FU(. ?)LOOMS 1.,A-NbSCt'tpi ualifying Agent:
Address IN 12 We1N oeitu,iN ¢p. SUIT I2-(p City (..)NC( O".JVlaState EL- Zip 31,2-2-(0
Office Phone 16q. 7 LH. Si wacv Job Site/Contact Number 'foK.so cj .513 5
State Certification/Registration# E-Mail ONN4Sl.F tivi CS
Architect Name& Phone#
Engineer's Name& Phone#
Workers 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 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
applicablelaws 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 FINA► CING, CONSULT WITH YOUR LENDER N ATTORNEY BEFORE
RECORDING YO R NOTICE;• r COMMEN ``MENT.
c --r /111,004
(Sig vire of O ner or N -nt) (Signature of Contractor)
cludin:'con ractor)
Signed and sworn to(or affirmed)before me this as day of Signed_ and sworn to(or affirmed)before me thiso day of
/11•01 M} , ���� , by ZI� � L.L(LLt Ptak .5-t- , am-
\ '
, ' �� \_VL
11ISi natur?r77:4,+]�`/ ,,1.. ignazti..•'�. ;• ')ON
irk:S ' JENNIFER JOHNSTON �r MY COMMISSION#GG 042•''" l.
27:2028
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- MY COMMISSION#GG 042984
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Irks. 7,, EXPIRES:October 27,2020 •-
[ I Personally Known OR '' eptA,S.••' Bonded ThruNotary Public Underwrite(s Personally Known 0 ; 84""'
QQProduced Identificationpp . roduced Identification
Type of Identification: cyl%ado-��S \,LU...144._ Type of Identification: �•(1`1 &t.
_0,44_
TREE VELE �f"A�t�:�N AFFlDAVJJT
Co sy®f AtB�ni� x Beach
r�' - Department of Community Development
tt .
Planning&Zoning Division
800 Seminole Road Atlantic Beach,FL 32233
(P) 904 247-5800 (F) 904 247-5845 PERMIT#
SECTION 0-APPLICANT INFORMATIONf
re,"tiwner(s) rLegal Authorized Agent*
NAME OF APPLICANT •o ., /
�, -ti _ C/C-Cr:r
NAME OF COMPANY
ADDRESS OF COMPANY7 411-4„7/7,he g,77
z
PHONE , v2,7$�,/2 CELL ,..)2 "7,5---(9 ./2,370MAIL j- CLc_c_2 Li��G. 4.„--.. ..„),,,,,
CONTRACTOR CERTIFICATION NUMBER
fi
ATLBCH BUSINESS TAX RECEIPT NUMBER
SECTION EP-SITE INFORMATION
STREET ADDRESS OF PROPERTY 77 `c `r 1, 1� /e,„ .1 FG - ,
6 7 y
If an address has not been assigned to this property,contact the AB Building Department at(904)247-5826 to request an address.
LEGAL DESCRIPTION %S •
BLOCK �1L p SUBDIVISION
�
LOT /,�•�3_LG_26.-......z 4� /TIt��� Iiel�lUar/nii fN��. ,..,/,_/�Lk
REAL ESTATE NUMBER/%2360 '0000 LOT OR PARCEL SIZE: SQ FT AC
RESIDENTIAL COMMERCIAL OTHER(SPECIFY)
LLT=7 L..'` . ., ta;'s,+ .;<4-`i s ,t �.p - ,;' .,* k;. $,t7 !"-' '"ki= **"a`,",., *° ;::,?_..?.i`'='':yy,,�ik*1a4'._. " F:,..}
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 s-.ch,FL and/or I have participated in a pre-application meeting with the Administrator of those
regulations. Subseque ly,I affirt at no regulated trees and no regulated vegetation will be damaged, destroyed and/or removed
from the above-descri Jed or adj. -nt properties in conjunction with this project.
11:
SIGNATURE 06 11FR SIGNATURE OF OWNER
� f
Signed and sworn before me on thisLeSay of pto,
,7C7, 7,by State of t—
1. J County of
Identification verified: f zoo " 4 ( 6 1 Gs_ D
Oath sworn: [ Yes f No V
4,:,,,,: ..... , • , ,,,i,-11P,b_
I, �a.„,f•.3� MY COLI GINL�LESPERGER •
~ u �-
1r�r MMISSION# 92 51
.,..,,,..._;t:qier::';:.,;Z--='1E?{PIRES:October 6 49 Notary Signature,+ Bended Thru Notary PublicUn 2019rri •- _ My Commission expires:
_ _..]
I — e — �..
S1
J `
' ' REVOCABLE ENCROACHMENT PERMIT
t.--.,.7; ,r:
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of AuusT ,20 It ,
by the City of 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 for the purpose as described in the City of Atlantic Beach Right-of-Way Permit# .
This work is generally described as
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 USER, said notice to USER shall be given by certified mail,
return receipt requested,to the following address
• 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."
• 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 within 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 right-of-ways and
other public land. USE: further agrees that the CITY and its officers and employees shall be saved harmless by
the USER from my •tt 'e work herein under the terms of this permit and that all of said liabilities are hereby
assumed by t► • US);
Date A7/2--1
Property Owne Agent(signed in presence of Notary Public) ��
STATE OF FLORIDA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this day ofIA,S 20 It
v ,
by T[ Qh jn'J LC__' ,who personally appeared before me and
(printed name of Signer)
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
'
Si '4 re of ,. ary i.lic, State of Florida
Approved/Public Works Department:
Personally Known
Produced Identification(Type)_6.r iJ 0-ik% \' Ung---
«""P�'e'• JENNIFER JOHNSTON ------7/,"/fi r , '�,��
• MY COMMISSION#GG 042984
"' ` ` Scott Williams,Interim Public Works Director i
. �.•o? EXPIRES:October 27,2020
...Q•g '' Bonded Thru Notary Public Underwriters
"' RIGHT—OF—WAY/EASEMENT PERMIT
r - s)
cl;tir)? Permit#Issued by the City of Atlantic Beach
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address 15-11A S`l Phone go Z,. 1 SO v 2
Permittee 30E 30 o/CE U]£C.Fr Email )oELucCfteUbeL.E-19U
Requesting Permission to Construct $CHUT1F14, ?ALUM l.A.N 9SC,Apl1V4
Location(Reference to Cross-Street) ertST COAST PP VE
• Permittee declares that prior to filing this application they have ascertained the location of all existing utilities,
both aerial and underground and the accurate locations are shown on the sketches.
• 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 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 Permittee unless reimbursement is authorized.
• All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed
under the supervision of DA3eAIIA (Project Superintendent)
located at 211 �S+IA Cl
s
• All materials and equipment shall be subject to inspection by the Director of Public Works.
• 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.
• 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-way are to be included with this application.
• The permittee shall commence actual construction in good faith within 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.
• 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 .lvileges.
• The Director of P bli orks shall be notified twenty-four(24)hours prior to starting work and again
immediately u.•n co .petion.
A 41
�-��� Date
Permittee(signed in%ince of Notary P blic) /
STATE OF FLORI DIA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this day of ,56.1S-k-- ,20 Ie- ,
by Zrts E-4?I A cit 4 Lti LL-A
who personally appeared before me and
(printed name of Permit-tee)
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
-1 AI �'`. ,� —
Personally Known
Signa ,•f Notary The, Stat- •i Florida r.t :. .entification(Type)
�;rnV?lcv�'c- JENNIFER JOHNSTON
5*:
t*: MY COMMISSION#GG 042984
ird
p' EXPIRES:October 27,2020
•••;of F�q,' Bonded Thru Notary Public Underwriters