2021 SELVA MADERA CT - PAVER PATIOS 00„,./_,..44
(0._
1. CITY OF ATLANTIC BEACH
5> 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
�;j 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: RESO17-0048
Description: TWO PAVER PATIOS
Estimated Value: 2000
Issue Date: 12/12/2017 •
Expiration Date: 6/10/2018
PROPERTY ADDRESS:
Address: 2021 SELVA MADERA CT
RE Number: 169506 1650
PROPERTY OWNER:
Name: BURBRIDGE H CLINTON
Address: 2021 SELVA MADERA CT
ATLANTIC BEACH, FL 32233-4531
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.
Ordered By: -7' ors ,
•
The Law Offices of Rod Schloth - . .
..
2187 S Third St
Jacksonville Bch, FL 32250 = r.
i
904-372-9351 G g - , ri 1
Bosh De Mat 1 1 . Vii._
beach®rod-law.com .ry
PROPERTY ADDRESS: 2021 SELVA MADERA COURT ATLANTIC BEACH,Florida 32233 SURVEY NUMBER: F_ 2`1.1036
FIELD WORK DATE: 11/14/2012 REVISION DATE(S):(rev.1 11/18/2012)
FL1211.1036
BOUNDARY SURVEY
/
DUVAL COUNTY
LOT 79
/
N 86°12'05"E 176.46'(1(A 'I FCM 4"x4"
N 86004'40"E 174.56 ' 1 Lb#3398
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a O
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24.3' LOT 80 3► - a4 °-/\( 33
LBi IF048 2 STY.RES 82021 a, 0 'OI n 8...b
�� LO
:,GONG DPoV;` to NO ACCESS _ 7' e,
,.\ N -/ 14.0
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N. O
i.2 ,,,, ��ro //—a—,/—a--a— /
N 84°51'23"W I58. ao .
Q�J�• N 84°51'23"W 159.52'(M� / o}p LW/I048
B.R. (PER PLAT) / /
r tome,
(74, 1-. •m
T" LOT 8 I ���
O
C-I TABLE:
R= 110.00'(P*M) L-15 18°30'00"W 24.24'(P)
L=66.28'(P) 66.50'(M) 5 18°25'43"W 24.25'(M)
,L=34°3 I'20"(P) 34°38'20"(M) L-2 5 7 1°30'00" E 50.00' (P)
N I°14'20"E, 65.28'(F) 5 7 I°14'06"E 49.94'(C)
N 0°5754" E, 65.49'(M) L-3 N 18°30'00"E 9.24'(P)
N 18°45'54" E 9.49'(C)
L-4 N 18°30'00" E 15.00'(P)
�� ,0 B. ,,n N 15°45'54"E 14.96' (M)
I hereby certify that thi .-ttgA of e�Yy one •e-on described property has
been made under my.ir-ction, . •hie best of, knowledge and belief,it is
a true and accurate r-p esr,1 lo• - . rvey that mets the minimum technical NOTES:
�i• • Y LOT APPEARS TO BE SERVICED BY CITY WATER.AND SEWER.
standards set forth b t e: .•.<����i, � •es al Land Surve ors as
described in Chapter o�17 of •-ST TE fi.aOAdminis..- Ve Code. FENCE OWNERSHIP NOT DETERMINED.
,t`5 FLORIDA P
s,0NA<S URVE'iO�to 40' 30' 20' l 0 0 20' 40:
. ,
Wesley B.Haas oo 'xrx
GRAPHIC SCALE
State of Florida Professional Surveyor and Mapper tong,
License No.3708 I inch = 40 feet
Use of This Survey for Purposes other than Intended,Without Written Verification,will be at the User's Sole Risk and Without Liability to the Surveyor.
Nothing hereon shall be Construed to Give ANY Rights or Benefits to Anyone Other than those Certified.
FLOOD INFORMATION: POINTS OF INTEREST
By performing a search with the local governing municipality or www. (1)6'WOOD FENCE OVER 50'EASEMENT.
fema.gov,the property appears to be located in zone X.This Property was
found in the CITY OF ATLANTIC BEACH,community number 120075,
dated 04/17/89. m"
i
Florida Land AFFILIATE
CLIENT NUMBER:RS12-1003 DATE: 11/18/2012
Title Association MEMBERS
BUYER:H CLINTON BURBRIDGE AND MICHELLE D BURBRIDGE FL'-TA
SELLER: PAMELA R BUSHNELL
CERTIFIED TO:H CLINTON BURBRIDGE AND MICHELLE D BURBRIDGE,
THE LAW OFFICES OF ROD SCHLOTH,PA;OLD
,.t
REPUBLIC NATIONAL TITLE INSURANCE COMPANY ik
www.surveystars.com
Land Surveyors, Inc. P 866-735-1916• F866-744-2882
This is page 1 of 2 and is not valid without all pages. LBe 7337 12220 Towne Lake Drive,Suite 55•Ft.Myers,FL 33913
� l-7-�AO� or k w i-41‘. re-tstQi. 1 l/ ZS3 /+ 7
01..A.vr,,, City of Atlantic Beach APPLICATION NUMBER
JsI, Building Department (To be assigned by the Building Department.)
800 Seminole Road 1�5 _ 00.4T ,, Atlantic Beach, Florida 32233-5445 Q
9., Phone
9 r E-mail:(904)bud n4-de8 t coab.u904)247-5845 s Date routed: I k Z8 Z d (7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
C T _
Property Address: Z02 SLv/ VIA-ptelepartment review required Yes/ No
!Building')
Applicant: a(.oN 2 �,,� r ,
_ Tree • •• . •r
Project: W U pAv>�Z pp,-„, c) , ,iblic Works
�u61ic 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: rcKpproved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
CgUILDING
PLANNING &ZONING !�. 3
Reviewed by: 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:
Reviewed by: Date:
Revised 05/19/2017
r .
„L Building Permit Application Updated 5/5/17
OFFICE COPY
T '`--- "� .i' City of Atlantic Beach
,`# 800 Seminole Road, Atlantic Beach, FL 32233
i3 YP Phone: (904) 247-5826 Fax: (904)247-5845 R C
Job Address: .202/ 5e�✓�, UV\0,�e t�G� 0--
Permit Number: t�s 01 - cD0
Legal Description RE#
Valuation of Work(Replacement Cost) $ 6.2/00(.7:— Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one):4 Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): CommercialResidential
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes 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:
Peivev- ?�.4- -2
( &5 L( — 1c.A-)0 P .-\1 e t Pot LO c ‘---6:344,1,L s40 i
le a.+ c-e_vt5to, -6 t7-fZr---)op- 30c,S
Florida Product Approval# for multiple products use product approval form
Property
Owner Information
Name: 7 /- (7.14'1.c(--o<.,. ��vZ9 ' . Address: .2O ( 3.e1,-, - tCLe v 67-(--
City
.A{,�„(—< r c,—aGt
State F.--L Zip 32.2.3 Phone 7o 4—,z-(2—`�.3-s2.
E-Mail hcb 3 (a'_ Gl< w4-1.,,,,,,,I,,,,-,-(.7,2_ .. Cdr __-"
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Qualifying Agent:
Address City State Zip
Office Phone Job Site/Contact Nu :er
State Certification/Registration# E-Mail
Architect Name&Phone#
Engineer's Name& Phone#
Workers Compensation
Exempt/In d rer/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
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 OBT IN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECO DING OUR NOTICE OF COMMENCEMENT.
,/ 4' A_ . _ --
(Signature of Owner or Agent) (Signature of Co" ractor)
(including contractor)
igned and sworn to(or affir z•1 before me thisZ I day of Signed and sworn to(or affir d)before me this day of
. _CD (7, by (3' Aia, r�� ...s...se_s. � , b
vim �:� (Signature of
Signature • ota" ( g Notary)
,:0=7i TONI GINDLESPERGER
• '= MY COMMISSION It FF 924951
• -o EXPIRES:October 6,2019
[ ]Personally Known OR V'f- "0� 6ondedThruNotayPub5cundery,iters [ ]Personally Known OR
[ ]Produced Identification --'7.7"''''''"'*'" [ ]Produced Identification
Type of Identification: Type of Identification:
04 _T CITY OF ATLANTIC BEACH
�` I 800 Seminole Road
z14-4- I Atlantic Beach,Florida 32233
REVISION REQUEST / CORRECTIONS TO PLAN REVIEW COMMENTS
Date /2- /7 Revision to Permit Corrections to Comments Permit# 1 7-RA DP-3065
of
Project Address 20 _ J - A _ . /I - N __
Contractor/Contact Name #-, G/fw'I--ot,. ju„•fac,.jf.e_ ...1-41
Phone GD(-2c.L2- '3 5.Z Email I nt, 6 01 (ct-1-1uvivt‘e4/e ,Co(4.-
Description of Proposed Revision/Corrections: Revision Review Fee Due$
►t< ec A (- ciô -
Additional
Increase in Building Value$ 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 / Denied Not Applicable to Department
Revision/Plan Review Comments
Department Review Required:
iilriinr G%%
:lanrRin . Zg;� gning Reviewed By
Tree A min
Public Works /
Public Utilities ! _ y — i 7
Public Safety Date
Fire Services
0s'-1 RECEIVED CITY OF ATLANTIC BEACH
0
A �� 800 Seminole Road
.. j� J Atlantic Beach,Florida 32233
NOV 3 ��t] Telephone(904)247-5800
• FAX(904)247-5845
T SHEET OR
COR` • T 1AIEW COMMENT
Date: //-/3-/7 Received by: Resubmitted:
Permit Number: /7— RA 7 7 ---o($
Original Plans Examiner: Project Name:
Project Address: .2O1;ZI sdu� ftilev-c CI A t--) fr.-E-<e• Ee --di F/ 3-2233
Contractor: 5 elf / (QW fri e I.- Contact Name: ('!,/,'‘,11-- 5't,(1,-1.,v1 Iq e
Contact Phone : 9•04 -,2.i./2.-9.35-,Z Contact e-mail: /i C b g (& ci i K-- bus-J .1>-/ge. c0,,1
IRevision/Plan Check/Permit Fee(s)Due: $ _ l
Description of Proposed Revision to Existing Permit:
4
./
Additional Increase in Building Value: $ Additional S.F.
Site Plan Revised: Public W/U Approval:
By signing below.I(print name) f/_ e4-14-1—t11.4_ B(4 trt,,Le:rig eCII affirm that the above revision
is incl sive of t1, proposed changes.
41-�` _ _ — / - 3
Signature of Contractor/Agent(Contractor must sign if increase in valuation) Date
Office Use Only
Date: Approved:_ Rejected: 7 Notified by:
Plan Review Comments:
/Gees
Department review required Yes No
1-uildinqD
ani ing &Zoning
Plans Examiner
Tree Administrator
� is Work37 Ji -3o- ' 7 -
Public Safety
Date Created 1/13/16 Rev.3
Fire Services
s ?St , y.6 RECEIVED CITY OF ATLANTIC BEACH
J . ''� 800 Seminole Road
�j `.0
.... ;r1 Atlantic Beach,Florida 32233
r NOV 1 3 2Oti Telephone(904)247-5800
FAX(904)247-5845
4� I �:.(119(ten SHEET OR
COR iIEW COMMENT NOV 1 6 2017
Date: //-/3-/7 Received by: Resubmitted: RES 0(7 -Co' i-
Permit
Permit Number: - r
I4)-RAD1) -2200
Original Plans Examiner: Project Name:
Project Address: .2.OJZ.1 SelVe%, fii _lP,,%. C A-Hat,4-<< He,-..ct, F(_ -3,,223,3
Contractor: Self / (Qc.)14efr- Contact Name: x'/;I,L( 3,.(v-bv1 f qe
Contact Phone :__Q. _. �/� _9�35? Contact e-mail: /1 c/. LE i t - b(4%-l)(,--,"4e.ccor'.r..
Revision/Plan Check/Permit Fee(s) Due: $ l
Description of Proposed Revision to Existing Permit:
7-Luc, Po„ev p7`f-,O S f-o-E—a // , vig s yc9 4
Additional Increase in Building Value: $ Additional S.F.
Site Plan Revised: Public W/U Approval:
By signing below.I(print name)_ /1_ e/4 ct4-ortLAvie)v,`�9 eJ/ affirm that the above revision
is incl sive oft proposed changes.
-t..,-- P — - - - // 1/3 --/7
Signature of Contractor/Agent(contractor must sign if increase in valuation) Date
oniee use Only
Date: Approved: Rejected: Notified by:_
Plan Review Comments:
De
c --
,-/..0.17./114‘0,0,fro-2_,..
,l ,
ildin
anning &Zoning
Tree Administrator Plans Examiner
(..-PtibTc Work-s• ---H
77/ (.7
lie Utilities
Public Safety
Date Crated 413/16 Rev.)
Fire Services
LL, _ —TOOL 00+ d(A)FA .-\—() ry-\,CI_( -- •-e— cL--. f- e--c-L)
p�r/v�_L.:(- r e r�
1 t�
�s* r RECEIVED CITY OF ATLANTIC BEACH
\e ) 800 Seminole Road IA
-a : J - -_ - Atlantic Beach, Florida 32233
O V� NOV 1 3 2017 Telephone(904)247-5800
FAX(904)247-5845
\-0;119U
' . eUtar SHEET OR NOV 1 6 2017
CORi a kw COMMENT
Date: //-/3-/7 Received by: Resubmitted:
Permit Number: /7 - R D7 - F065 ) I6-RAD D- 22Ob
Original Plans Examiner: Project Name:
Project Address: <o,,Z,1 cSe,(Wi i ictc I 'vc el--: A f-]a c(--<r Ee‘•c_Ct F(_ �,,Z233'
Contractor: 5 e j cr / pc..)vi e fr- Contact Name: r/,';t f 8,4v-by-id g e___
Contact Phone : gp4_ -,gyContact e-mail: h e b 3 Ci l'K-f- bu%-1,r,--,,-1 y ; Corte
Revision/Plan Check/Permit Fee(s) Due: $
l
Description of Proposed Revision to Existing Permit: n
-7-600 pkVPtl Don-�;os 1--o4--a% // . v(cj 5`�Q ¢ _______
Additional Increase in Building Value: $ Additional S.F.
Site Plan Revised: Public W/U Approval:
By signing below.I (print name) 7U- C/t Pr-F-ort RN.l - v,rig e fIL affirm that the above revision
is incl sive oft,• proposed changes.
et
AV - i -a - _ - -7--__. // - /3 -/7
Signature of Contractor/Agent(Contractor must sign if increase in valuation) Date
n
Office Ilse Only
Date: (((2.t i( 7 App rd: /�(' _ Rejected: Notified by:— --------- - -
Plan Review Comments: N
De artment review required Yes No I /
uildin 1/6„
anning &Zoning
Tree Administrator Plans Examiner
tc Worc - t,✓e..� (1 L(7 ( 7
lie Utiliti -
Public Safety /1/7-/-7 Date freaml//13/16 Rw)
Fire Services
'j F RECEIVED
CITY OF ATLANTIC BEACH
800 Seminole Road
Atlantic Beach,Florida 32233
al i
Zs'
N O V 1 2017 Telephone(904)247-5800
FAX(904)247-5845
1' 1• SHEET OR
COR ` i W COMMENT
GSCL 7 48
Date: 11-13-/7 Received by: Resubmitted:
Permit Number: /7- RA DD X065
Original Plans Examiner: Project Name:
Project Address: z 002,i um /11 a IeC 1L A e e,c_Gx .3,,223,'
Contractor: 5 el f l OC,)1,1 e w Contact Name: 1-'1;1,4 Bu,rb,�, 9 e—
Contact Phone : q0L/ - ,& Contact e-mail: Ii e b 3 el i 11.4- leu,-�,
Revision/Plan Check/Permit Fee(s)Due: $
Description of Proposed Revision to Existing Permit:
7'wo- PRvepoht-,`05 -1--c?-1--e;- // ,(.7 5'IQ
Additional Increase in Building Value: $ Additional S.F.
Site Plan Revised: Public W/U Approval:
By signing below.I(print name) �_ ,c�-I-v i& 13c t vh,..� 9 e affirm that the above revision
is incl sive oft 1_ proposed changes.
dr.( _ _ - I, // /3 -/7
Signature of Contractor/Agent(Contractor must sign if increase in valuation) Date
Office Ilse Only
Date: //-2- 2- Approved. Rejected: )C Notified by:
PlanReview Comments: /�
/7 S Cpd rptB r yr!a ,- 1 i 1 � ,
-e , r d !& 11-e
na
1-- ' Q'1 fre Yd 3 .
De artment review required Yes o
11fa
uildin
anning&Zonin�
Plans Examiner
Tree Administrator
/P le ore //,2.2"4-3
lie Utilities 6 —
Public Safety
Date crested 4/13/16 Rev.3
Fire Services
;� � l� C it
y�L.) � �.Ci� c� a /V4 �- `� v
CS
C�'0/O
petit; i 0 as-
-ck-Twvact,
tF'
e. r
II m ` ' ji dace CakTi��iaflonR % ! o 'Y ige
Find square footage of the following:
House footprint - I, S Y 7 7 4
► Driveway - 6 s e
AP sidewalks/walkways-2 /2 4
A/C pads - 1 dd +Detached garage/sheds 0
Pool Decking - td/A
Patios, terraces and/or decks N /4
Add the total square footage of the areas listed above then, divide the sum by
the total lot area of the properly.
� U - 15870
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FL1211.10 16
BOUNDAR SURVEY /
DUVAL CO NTY
LOT 79 i r i/ i ;
N 86° 12'05" E 17b.48' (M)
N 86°04'40" E 174.56 (P) LB# 4X4"
398
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