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2228 OCEANWALK DR W - DRIVEWAY CITY OF ATLANTIC BEACH 1 Vis) 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 'ton r-) PHONE LINE 247-5814 DRIVEWAY - SINGLE OR TWO FAMILY DRIVEWAY MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: DWAY17-0018 Description: replace existing concrete driveway & sidewalks with pavers Estimated Value: 9000 Issue Date: 10/6/2017 Expiration Date: 4/4/2018 PROPERTY ADDRESS: Address: 2228 W OCEANWALK DR RE Number: 169463 0536 PROPERTY OWNER: Name: ROICK JAMES A Address: 2228 OCEANWALK DR W ATLANTIC BEACH, FL 32233-4575 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: C.A. Morrison, Inc. Address: 11533 Joance Lane Jacksonville, FL 32223 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. 01.Al City of Atlantic Beach APPLICATION NUMBER Js -• J1 Building Department (To be assigned by the Building Department.) r - t`-'-., 800 Seminole Road e �1 -5:,,iir�e Atlantic Beach, Florida 32233-5445 ��R ! ii OO Phone(904)247-5826 • Fax(904)247-5845 O /c��I 13 Al:',.. �%' E-mail: building-dept@coab.us Date routed City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: aaa 11 vV • OCea.nwe( Ir_4 ' Department review required Yes No Building Applicant: 1' A - MO(1i O(\4 L•Plarsning &Zoning] 1 Tree Administrator r Project: 1 1pl(4iir (\eci CL,' J (A44,4, d- (.1.2_ Wo'r<s s t&20a1_ c 0 `' ,` a JQS PublicSaf Safety l�-� �1J 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: ,/ pproved. Denied. Not applicable (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by/* ,4--' Date:61-27/7 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 Y Js 'r-� Building Permit Application _ E Q VU Eea5/5/17 C V 7 y City of Atlantic Beach xr 800 Seminole Road, Atlantic Beach, FL 32233 SEP 2 2 201 ..o'3°' Phone: (904) 247-5826 Fax: (904) 247-5845 gyp /� Job Address: .2 - ()CCP')I.1 C,-))1)K Oc . (..J . Permit Number: DWAM ,l -0 01 g _ Legal Description 'f,,2-/3• 7-015 -,32-9 L.,,..1-3/oce.11,01.,,n.p4 0„„)T.2 RE# 4'9W3-653G Valuation of Work(Replacement Cost)$ 9 . " Heated/Cooled SF 4U/ 441 Non-Heated/Cooled WI) • Class of Work(Circle one): New Addition Iteration Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one : CommercialResid • If an existing structure, is a fire sprinkler system installed?(Circle one): Yes C.,- 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: t,�14 e-e 7h r F�is,i; 'g- Co. rc.ie_ O,),«ryy d- 5:dt'n1Xs £J / 174✓c{S Florida Product Approval# for multiple products use product approval form Property Owner Information Name: ,i Jim e- 5 / q;CI( Address: ,2228 ©Cel9� it)K Vt. W t City AT/ANTI e-- OP', State `L. Zip yg,2.2 3 Phone `/v C) '9.23-.23 77 E-Mail J LTC- t A a ) • In ,y Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company: C A IOfr.►f,,kj7, 'j c Qualifying Agent: Cif y 1.�y� e rc,so/) Address 11S-g_.? N'C/G ,CN. City Jeri ✓i//C/State ick._ Zip c. .212.3 Office Phone 9e(_) -gj3 '39 lir Job Site/Contact Number 94 y -b 3 - 3946-- State 9Q State Certification/Registration# E-Mail CR/17o rr iso/V. C-- a&A aui11 .io e Architect Name& Phone# Engineer's Name& Phone# Workers Compensation 4/// "J2O / r xempt Insurer/Lease Employees/Expiration Date Application is hereby made to obtain a permit to do tfie 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 regulating 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 RECORDIYCIUR NOTICE OF CO NCEMENT. 7/ y / .:.(Signature of Owner or Agent) CZ (Signature of Contractor) (Including contractor) Signed and sworn to(or affirmed)before me this a day of Signed and sworn to(or affirmed) before me this•�a day of e.Q4..r41,t, aD['k , by X.rt12-S Akan 'D Lk- syttioar , aol- , by C&r•-t klA(1 kort:so r) 1 '411�- - ,/. (Si• . ire of Notary) i ,,,,,o,:,=,,;.' .,. JENNIFER JOHNSTON t"?.......1A MY COMMISSION#GG 042984 4:y"�••. JENNIFER JOHNSTON •*' 1""'' 'R= EXPIRES:October 27,2020 ;*. ! ti,_ MY COMMISSION#GG 042984 iia �� = - EXPIRES:October 27,2020 .";'6'p,'�u,. BondedThruNoaryPublicUnderwriters_ ersonally Known OR ••:,�%f�°t•' Bonded ThruNotary Public Underwriters iiit.[ ]Personally Known OR _ — , "Produced Identification — [I.Produced Identification Type of Identification: -(tJ¢-j,. 1 tLQ(S Type of Identification: de,JJ.(ts VILLA.I� City of Atlantic Beach APPLICATION NUMBER JSl Building Department (To be assigned by the Building Department.) - "`ll 800 Seminole Road ^��� I�rO� 17 �..Y f Atlantic Beach, Florida 32233-5445 1.J Phone (904)247-5826 • Fax(904)247-5845SFP 2 5 2017 09 WI In " "bU;319r E-mail: building-dept@coab.us 3 Date routed: 7 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: aa'aN O tithWei t1`-1(. Department review required Yes No A Building A Applicant: ' - l4O(fISO(\( • Planning & Zoning Tree Administrator Project: (10aLe._ etiv-rat_ 61,4:d a d Public or s Public Utilities t&L )CL 1_S W t V y aV P-Ls 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: APTCATION STATUS Reviewing Department First Review: Approved. ❑Denied. ❑Not applicable (Circle one.) Comments: BUILDING z. PLANNING &ZONING Reviewed byr J0*_40.0Date: TREE ADMIN. Second Review: Approved as revised. nDenied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ❑Denied. nNot applicable Comments: Reviewed by: Date: Revised 05/19/2017 351 z: REVOCABLE ENCROACHMENT PERMIT 4: 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 jiff m G 5 A R(3 i GK 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 4/7;yjgi `s) Q4, 404 � � newt/4- D,.re 1,,,,gy 6,2277 A vc y r • 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 .212 p mecs,✓a,nIx D,-. Id . Ali e Seyirh1 (,L . • 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 I rther agrees that the CITY and its officers and employees shall be saved harmless by the USER from . _ • e work herein under the terms of this permit and that all of said liabilities are hereby assumed by t - 1 S .' . �— Date Property Own. /Agent(signed in presence of Notary Public) STATE OF FLORIDA, COUNTY OF DUVAL The foregoing instrument was acknowledged this or— day of St-p-ke(l ,20 (1 , by la M tS Pc I(n tl.csi,0— ,who personally appeared before me and (printed name of Signer) acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. Sign e of tart' iblic, State of Florida Approved/Public Works Department: Personally Known .,, ,�.9vL JENNIF - a _ �. 1: _%. MY COMMISSION#GG 042984 � '7;;;""j " EXPIRES:October 27,2020 / /J/, Zi �-` :�;Rp7F,.o?; Bonded Thru Notary Public Underwriters ScottWilliams,Interim'u, is Works I'rector A J 4, RIGHT-OF-WAY / EASEMENT PERMIT 01:19 Permit# Issued by the City of Atlantic Beach PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES Job Address 422.2$ Dc¢l N wnix ®r. to ` . Phone 96`f - ?6,t.7 Permittee ✓A ry1 a 5 ie© ; G k Email J rc e Rob to m Requesting Permission to Construct R ep1nc,c led uerri Dr,;we isy `,,,J 7 Pi rc rs Location(Reference to Cross-Street) 5 n7 J-0/e.. i • 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 1::,?lay me ee SO,%/ (Project Superintendent) located at 0 .1U 2 04,_aktnjw0/i Or Lu • 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 ri! . d privileges. • The Direc . of ' blic Works s be not' d twenty-four(24)hours prior to starting work and again imm-e.ately . 'on corn leti . Date Permittee -'gned in presenc of Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL 11 ee __i � e / The foregoing instrument was acknowledged this a).- day of s Lf -fr 'tel ,20 , by 3 a.rt•- ...S A 1a A E-0 LA ,who personally appeared before me and (printed name of Permittee) acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. �I \ Sign. e of No Pu•'�c, to of Florida Y P JENNIFER JOFItI§ ed I tification(Type). ( yP ) 0. r el PA S��C erls�2 � �= MY COMMISSION#GG 042984 EXPIRES:October 27.2020 %'.a aa; Bonded Thru Notary Public Underwriters /end x9 ,(em 301 H9AY .05 1$.9A4 3/1 I br p X 7 V/14 /Y 13 P' 0 _[/Y.Ff-v_A O ,' 176if9d$'b' P-C-' 'POd/ =b'-s,.Zig S'g =V PF',zO.�O =p pao-- s��l�'rv� 1 do 1 d-�r.a. ,00 'SA =H „. (-,5'0aSO ;C i „..-- .064-5”,-3-,r- (� 1 rfifrov 67J KO'd”-'f / ',co*/ , •. • o . V• 7[SPE/oclid r\ Ni uo�%s/Fvavi \ Ain ,a I '' .' '1) .` , • . *.k .y/erol/9 i S *P k 1,s: ‘ •IV' - , . 1 -2-4:,,*‘. _ 4. 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