1542 PARK TERR W - PAVER DRIVEWAY CITY OF ATLANTIC BEACH
> 800 SEMINOLE ROAD
�� ATLANTIC BEACH, FL 32233
'40.2 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: DWAY17-0022
Description: REMOVE CONCRETE DRIVEWAY AND REPLACE WITH PAVERS
Estimated Value: 0
Issue Date: 10/27/2017
Expiration Date: 4/25/2018
PROPERTY ADDRESS:
Address: 1542 W PARK TER
RE Number: 171940 0000
PROPERTY OWNER:
Name: COLEMAN CYNTHIA
Address: 1542 PARK TER W
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: KETTELL INC.
Address: 1860 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.
i�L�� City of Atlantic Beach APPLICATION NUMBER
6S .; Building Department (To be assigned by the Building Department.)
800 Seminole Road 19 '\w L 7 `DO?Z_
,� _ s�, Atlantic Beach, Florida 32233-54450�� T +�
Phone (904)247-5826 • Fax(904)247-5845
'moi J;lir'- E-mail: building-dept@coab.us Date routed: J 0 /1 $5./1 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 s4-z Pte* (C-� & Department review required Yes No
II _ Building
KApplicant: E I TELL- I N Q__.- Planning &Zoning"--"N_
Tree Administrator
Project: P ve-R., D RL v>-wpc y - ublic Wor< -
J 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 ( P'
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. I IDenied. ['Not applicable
(Circle one.) Comments:
BUILDING
c
PLANNING &ZONING
Date: r/77'f//
Reviewed by:
TREE ADMIN. Second Review: nApproved as revised. Denied. Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. I !Denied. nNot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
r51-tvi City of Atlantic Beach APPLICATION NUMBER
r � Building Department (To be assigned by the Building Department.)
s: 800 Seminole Road A 1 y 0OZ
\�ll
J
Atlantic Beach, Florida 32233-5445 �`1 (VI /
Phone(904)247 5826 • Fax(904)247-5845 %
1 01110. E-mail: building-dept@coab.us Date routed: 10 II g
i 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 S4Z Pte, (C-12- Department review required Yes No
II K N Building _
Applicant: E 1 I au-- t Q _ Plannin• &Zoning
Tree Administrator
Project: P t v- D i-zt ew'yclrublic Wo -
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 ( f)'
St.Johns River Water Management District 4 C./
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: , Approved. Denied. Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING /
Reviewed by: ‘,/-* --- Date: (67- la—T.?
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
.. „4,..,.„
Building Permit Application Updated 5/5/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
j,,,Y
Phone: (904) 247-5826 Fax: (904) 247-5845 ;� {�
Job Address: ( 9G( - P•I'/Z 're4-' -‘'s CL 1/14 j 7 Permit Number: `�� ' `1/4-t r7 00 2...Z..
Legal Description 77`G 4_ L5 *-7q€ 914/27oo na l/n,tZ Cdf b 6�/Iick RE# 17/ '7 Le 0000
Valuation of Work(Replacement Cost)$ 13 1 Set 7- Heated/Cooled SF /I Non-Heated/Cooled4/1
• Class of Work(Circle one): New Addition Alterat Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No
• 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:
Ie-tie Co,n/,t't- an Ye i- k 4 r /4 Ce 1-);h- Pm.4 5
Florida Product Approval# for multiple products use product approval form
Property Owner Information f /. j' /
Name: (. li4, e,r-r -6 r. r Address: /5117 z 1/`t Itcrki-e_�uttiesok
City IVV(4,.. 9 L { t a- St to r L Zip 312-3 3 Phone_geg 0-7/6 t o 6 4 40.7
E-Mail G'SL c le. .r, 7/e' 0-- 6rvt a,;/. c e' —
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information 144-1a,1,-,6,
`,"�},,�/� �C /
Name of Company: !�y / Qualif i g Agent:"�14 l.P'1"
Address 10 O mCc-,, �+p''l- A e-el City Arvh t,/ c✓� State rL Zip 322 3 '3
Office Phone *II 31't lZT_e Job Site/Co",tact Numbef 1C }si lief/ fell 371 /mg
State Certification/Registration# E-Mail ON /6/..7P&It • teev.�
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation CON PA
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
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.
/2 .b,.. ; aGieZia _...---, ...,iairdirde- ..AIIIIIIP,111111r
(Signature of Owner or Agent) (Signa . - of ontractor)
(iricl.o :contractor) t`-7
Si ned nd sworn to(or a :"1, bef• me this day f Sig ed nd s torn to(or of :•)before me this` [ day of
C , Ol.b . MA* ' -1 n.p Uo 0 c ' . 4.
......_..,-e-,..!:._.-..- -,re2 .22....-.2!---- .r--- WAIL
Igiltift
, ,,.,„ ,,,
°..i '' TONI G (Sign: ure of Nota (Signature of Notary) /
`.s MYCOMM1 ,; rr ,.)1 i
'a EXPIRES October 62019 7CNlGINDLESPE-;��'ii
'14;,.9:q 4P' Bonded Thrc Notary P c incernriierc ( [-1). ,: MY COMMISSION tt FF 924951
EXPIRES October 6,2019
[ ]Personally Known OR \ Personally Known OR BcndedThr,Noan°b4cunderun,ers
tproduced Identification 1� J C_... [ 1 Produced Identification y = .--
Type of Identification: Type of Identification:
NOTICE OF COMMENCEMENT
State of County of ((1 1.)1.)CLA Tax Folio No.
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: 1:1-6 /6-ZS -ZA t cell .Monc V n I t
_I t- 1t* 3 R E I-11 @Ko
Address of property being improved: I SV Z cr i,P f'rr ze.
General description of improvements: RPM eve (pry,{ L d1/ +.. r� 4 (pf/Q s€
Owner: CA n711,Iirkt. 'M Address: / 5-1/z126
4/ f Y4.I 1.451-
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
tj Name:
n Q `1 ontractor: /Xeat ZilL_
Address: 1 g O goad
Telephone No.: 'My 37Z c_z6 Fax No: •
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
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 from the date of recording unless a different date i
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed Date: IO it 7 A 7
Before me 's i 7 day of� )S in the County of Duval,State
Doc#2017245815,OR BK 18164 Page 1883, Of Florida,has personally appeared (
Number Pages:1 Personally Known: or
Recorded 10/27/201710:29 AM, Produced Identification: S Z- - .-. , g --
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Notary Public:
COUNTY
RECORDING $10.00 My commission expires:
:r •. , - TONI GINOLESFERGO
-4i as MY COMMISSION#FF 924951 11
EXPIRES:October 6,2019
yl , Bonded Thru Notary Pubic Underwriters
I'• ip.,Altd-
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r
to
r15 4:Iwo);
1 REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT,issued on this day of 20
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 ,n f t itA (D/e..r,,a,
of Atlantic Beach,Florida,hereinafter referred to as SER".
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 ffe ercise 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 154Z Air7~ f k c
• 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. 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.
I Lc. Date / 7 (( 7
Pro;•rty Owner/Agent(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this f"7 day of 00.._4__ 20
1 7 ,
by hkl 4' _ 'e .` t r1 k ,who personally appeared before me and
(pri ed name of Signer)
ackno :ed that- e signed the instrument voluntarily for the purpose expressed in it.
0
_ A4 ,.., ,
Signature of Notary Public, State of F orid.
Approved/Public Works Department:
Personally Known ;
Produced Identification '• -(o 7 S� w
T c 9ISSIQN#EF 9 / C/�
t z NI GISSION 8 EF 924951 `/J ��
EXrit October 6,2019 s Interim Public orks Director
,,,-:.• ucrrdcd T:.,•,; "y Public Underwriters Scott 1 ,
I
,T1
/ ._ RIGHT-OF-WAY/EASEMENT PERMIT
,f, Permit#Issued by the City of Atlantic Beach
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address 'S'/7 IP Pik' kn- z,L2 (,h,j' - Phone qOl, 7/, 6'/G 7
..
6 �_-
Permittee ht /, 7G�1 Email C. 1 ° a n �-j
71��� ,,� .
Requesting Permission to Construct `I(kP ,Zc
//, �.,�,
�-�Vit,,
.,
LocationReference to Cross-Street)) SPrnnirl0le Piat1
• 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
'`J /
Beach or FloridadaDepartment of Transportation Standards and be performed
under the supe ision of /4, fL. / (Project Superintendent)
located at 1 v/€/'/ vhf /$ Q /79 „,-/-R,,,/ , Z Z 3 3
• 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 privileges.
• The Director of Public Works shall be notified twenty-four(24)hours prior to starting work and again
immediately upon completion.
i/i i, _.4, i c Date 10/i7 (( 7
Per;j ttee(signed in presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL ( �j
The f regoing instrument was acknowledged this I`7 day of 0 20
by t I Q, 0120 kin a t\ - A&-t '
1�e /� ,who personall a eared before me and
(printed name of Permittee)
ackn edged h she signed1.o�r"y';, TONI COMMISSIONI #ERGER
g the instrument voluntarily for the purpose expressed in it. 1 2 , MY FF 924951
I .z EXPIRES:October 6,2019
Bonded Thru Nc:ay Public Underwater.
Personally Known
Signature of Notary ublic, ja f Florida Produced Identification(Type) J 4 52.-10 3" '1-7 S5--C
1
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rs, �, TREE & VEGETATION AFFIDAVIT
7 r..- , City of Atlantic Beach
I frv._" --... Department of Community Development
'','r "~ Planning&Zoning Division
. 800 Seminole Road Atlantic Beach, FL 32233
(P) 904 247-5800 (F)904 247-5845 PERMIT#
SECTION I-APPLICANT INFORMATION Owner(s) E Legal Authorized Agent*
NAME OF APPLICANT Cr40 Airk 4lei-rm.-)
i4c/j4//NAME OF COMPANY (
ADDRESS OF COMPANY Si 119Arlpef/- e ea,�oPHONE lC CELL ,/ �( � �� '�4y 37z 71,6go y j77/0063-EMAIL I n� Klt���/hC • CDM
CONTRACTOR CERTIFICATION NUMBER
ATLBCH BUSINESS TAX RECEIPT NUMBER
SECTION II-SITE INFORMATION /
STREET ADDRESS OF PROPERTY l 3 L(Z
Rfi r-r8i Le t _k q--tIf an address has not been assigned to this property,con-a��ctt tthhe AB Building Department at (904)247-5826 to request an address.
LEGAL DESCRIPTION 71 -6 t 'o_ 7 S_ 2A ji
LOT 6 BLOCK 3 SUBDIVISION r�l✓(t WA4 U;'/2-
REAL
7LREAL ESTATE NUMBER 1701,10 _000 LOT OR PARCEL SIZE: Gill SQ FT AC
RESIDENTIAL \/ COMMERCIAL OTHER(SPECIFY)
I affirm that 1 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, 1 affirm that no regulated trees and no regulated vegetation will be damaged, destroyed and/or removed
from the above-described or ad'acent properties in conjunction with this project.
, 1.. 410,e47ica-a—
SI Ii ATURE OF OW 1 ER SIGNATURE OF OWNER
Signed and sworn before me on thi47 day ofc( ,Z((7,by State of ' (
County of bC.� Vim(
Identification verified: v 45 :�' 03 - 2
Oath sworn: Yes (— k. r
,....._ 4. Or 4 fa.
Notary Signature
trN'ii14f;�ESPER6ER
14Y COMMISSION M FF 924951
My Corn mission expires: - EXPIRES:October 6,2019
MAP SHOWING BOUNDARY SURVEY OF:
LOT 6, BLOCK 3, SELVA MARINA UNIT NO. 2 AS RECORDED IN PLAT BOOK 27,
PAGES 6 AND 6A OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA
S:
LOT 7
r t
O O
—+ PLAT
175 � IRO"
PIPE
N )r 174.63 MEASU ouND 11:TIFICATION •�
N78°03110° 0,24„E "° � �
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C�_ \�. n 7t� FOUND ENTIF CATION
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NOTES'
THIS PROPERTY LIES IN FLOOD ZONE X” PER FLOOD INSURANCE RATE MAP
(FIRM), DUVAL COUNTY, COMMUNITY No. 120075, MAP/PANEL No.
12031C-0409-H, REVISED JUNE 3, 2013
BEARINGS BASED ON THE WEST RIGHT-OF-WAY LINE OF
PARK TERRACE WEST AS BEING SI1'56'50"E
40' BUILDING RESTRICTION LINE (B.R.L.) BY PLAT P
N.T.S. DENOTES NOT TO SCALE O
ALL LOTS SHOWN HEREON LIE WITHIN BLOCK 3 CERTIFIED Mr
-X— DENOTES 4' WOOD FENCE EXCEPT AS NOTED CYNTHIA COLEMAN ‘ 0\''C �p
OF
THERE MAY BE ADDITIONAL RESTRICTIONS THAT ARE NOT SHOWN ON `�\\\"'�\G�
THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF (i
DUVAL COUNTY, FLORIDA. \°C)
1
I hereby certify that this survey meets the
ISI '
minimum technical standards as set forth by
DURDEN1 the Florida Board of Land Surveyors, pursuant to
Section 472.027 Florida Statutes and Chapter
SURVEYING AND MAPPING, INC. 5J17 Florida Administrative Cod
1825-B 3RD STREET NORTH I
JACKSONVILLE BEACH, FLORIDA 32250
I (904) 853-6822 FAX 853-6825 g/igezeit
le")
LICENSED BUSINESS NO. 6696
FLORIDA REGISTERED SURVEYOR No. 4707
H. BRUCE DURDEN, Jr.
SURVEYOR'S NOTE'
THE SURVEY HEREON WAS MADE WITHOUT THE BENEFIT OF ABSTRACT OR SEARCH OF TITLE AND SIGNED OCTOBER 9, 2017
THEREFORE THE UNDERSIGNED AND DURDEN SURVEYING AND MAPPING, INC., MAKE NO CERTIFICATIONS
REGARDING INFORMATION SHOWN OR NOT SHOWN HEREON PERTAINING TO EASEMENTS, CLAIMS OFSCALE: 1" = 20'
EASEMENTS, RIGHTS-OF-WAY, SETBACK LINES, OVERLAPS, BOUNDARY LINE DISPUTES, AGREEMENTS, - 919 4
RESERVATIONS OR OTHER SIMILAR MATTERS WHICH MAY APPEAR IN THE ABSTRACT OR SEARCH OF TITLE. WORK ORDER NUMBER: 17630
THIS SURVEY NOT VALID UNLESS THIS PRINT IS EMBOSSED WITH THE SEAL OF THE ABOVE SIGNED.